皮肤自体荧光测量在亚临床动脉粥样硬化疾病中的应用：ILERVAS 项目的结果。
Skin Autofluorescence Measurement in Subclinical Atheromatous Disease: Results from the ILERVAS Project.
机构信息
Endocrinology and Nutrition Department. University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) research group. IRBLleida. University of Lleida.
Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R). University Hospital Arnau de Vilanova. Vascular and Renal Translational Research Group. IRBLleida. University of Lleida.
出版信息
J Atheroscler Thromb. 2019 Oct 1;26(10):879-889. doi: 10.5551/jat.47498. Epub 2019 Mar 6.
AIM
Advanced glycation end-products (AGEs) have been involved in the atherogenic process in the high-risk population. The goal of this study was to demonstrate that AGEs are related to subclinical atheromatous disease in subjects with low to moderate vascular risk.
METHODS
A cross-sectional study in which 2,568 non-diabetic subjects of both sexes without cardiovascular disease were included. Subcutaneous content of AGEs was assessed by skin autofluorescence (SAF) and subclinical atheromatous disease was measured by assessing the atheromatous plaque burden in carotid and femoral regions using ultrasonography. In addition, serum pentosidine, carboxymethyl-lysine (CML) and AGE receptors (RAGE) were assessed in a nested case-control study with 41 subjects without plaque and 41 individuals subjects with generalized disease.
RESULTS
Patients with atheromatous plaque had a higher SAF than those with no plaque (1.9 [1.7 to 2.3] vs. 1.8 [1.6 to 2.1] arbitrary units (AU), p＜0.001). The SAF correlated with the total number of affected regions (r= 0.171, p＜0.001), increasing progressively from 1.8 [1.6 to 2.1] AU in those without atheromatous disease to 2.3 [1.9 to 2.7] AU in patients with ≥ 8 plaques (p＜0.001). A correlation was also observed between SAF and the total plaque area (r=0.113, p＜0.001). The area under the Receiver Operating Characteristic curve was 0.65 (0.61 to 0.68) for identifying male subjects with atheromatous disease. The multivariable logistic regression model showed a significant and independent association between SAF and the presence of atheromatous disease. However, no significant differences in serum pentosidine, CML, and RAGE were observed.
CONCLUSIONS
Increased subcutaneous content of AGEs is associated with augmented atheromatous plaque burden. Our results suggest that SAF may provide clinically relevant information to the current strategies for the evaluation of cardiovascular risk, especially among the male population.
目的
晚期糖基化终产物（AGEs）参与高危人群的动脉粥样硬化过程。本研究的目的是证明 AGEs 与低至中度血管风险的受试者的亚临床动脉粥样硬化疾病有关。
方法
这是一项横断面研究，共纳入了 2568 名无心血管疾病的男女非糖尿病患者。通过皮肤自发荧光（SAF）评估 AGEs 的皮下含量，并通过超声评估颈动脉和股动脉区域的动脉粥样硬化斑块负担来测量亚临床动脉粥样硬化疾病。此外，在一项巢式病例对照研究中，评估了 41 名无斑块和 41 名有广泛疾病的个体的血清戊糖、羧甲基赖氨酸（CML）和 AGE 受体（RAGE）。
结果
有动脉粥样硬化斑块的患者的 SAF 高于无斑块的患者（1.9[1.7 至 2.3] 与 1.8[1.6 至 2.1] 任意单位（AU），p＜0.001）。SAF 与受影响区域的总数相关（r=0.171，p＜0.001），从无动脉粥样硬化疾病的患者的 1.8[1.6 至 2.1] AU 逐渐增加到≥8 个斑块的患者的 2.3[1.9 至 2.7] AU（p＜0.001）。SAF 与总斑块面积也存在相关性（r=0.113，p＜0.001）。识别有动脉粥样硬化疾病的男性受试者的受试者工作特征曲线下面积为 0.65（0.61 至 0.68）。多变量逻辑回归模型显示 SAF 与动脉粥样硬化疾病的存在之间存在显著且独立的关联。然而，血清戊糖、CML 和 RAGE 没有显著差异。
结论
AGEs 皮下含量的增加与动脉粥样硬化斑块负担的增加有关。我们的结果表明，SAF 可能为当前评估心血管风险的策略提供临床相关信息，尤其是在男性人群中。
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