Doi Toru, Inoue Tomohisa, Sugaya Jun, Horii Chiaki, Tozawa Keiichiro, Nakarai Hiroyuki, Sasaki Katsuyuki, Yoshida Yuichi, Ito Yusuke, Ohtomo Nozomu, Sakamoto Ryuji, Nakajima Koji, Nagata Kosei, Okamoto Naoki, Nakamoto Hideki, Kato So, Taniguchi Yuki, Matsubayashi Yoshitaka, Tanaka Sakae, Okazaki Ken, Oshima Yasushi
Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan; Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.
World Neurosurg. 2025 Feb;194:123556. doi: 10.1016/j.wneu.2024.12.015. Epub 2024 Dec 28.
To clarify the association between skin autofluorescence of advanced glycation end products (AGEs) and clinical outcomes and pain in patients with degenerative cervical myelopathy (DCM).
Consecutive patients with DCM were prospectively enrolled. AGEs assessed by skin autofluorescence (the AGE score) were examined at the middle fingertip in eligible patients. Patients were divided into lower AGE score (AGE-L) and higher AGE score (AGE-H) groups based on a cutoff AGE score of 0.54. Demographic data, laboratory data, maximum spinal cord compression, clinical outcomes, such as European Quality of Life-5 Dimensions, Neck Disability Index, and Japanese Orthopaedic Association score, and Numerical Rating Scale (NRS) score for neck, arm, hand, leg, and foot pain were compared between the two groups. Multiple linear regression analysis was performed to assess the association between the AGE score and the NRS score for pain in the lower limbs.
Of the 263 patients, 93 were included in this study (41 with the AGE-L group and 52 with the AGE-H group). Demographic data, laboratory data, maximum spinal cord compression, and clinical outcomes were comparable between the two groups. The AGE-H group had significantly higher NRS scores for leg and foot pain than the AGE-L group. Multiple linear regression analysis revealed that higher AGE scores were significantly associated with more severe pain in the lower limbs in patients with DCM.
Noninvasive skin autofluorescence of AGEs may be a useful biomarker for pain symptoms in the lower limbs in patients with DCM.
阐明晚期糖基化终产物（AGEs）的皮肤自发荧光与退行性颈椎病（DCM）患者临床结局及疼痛之间的关联。
前瞻性纳入连续的DCM患者。对符合条件的患者在中指尖检测通过皮肤自发荧光评估的AGEs（AGE评分）。根据AGE评分临界值0.54将患者分为低AGE评分（AGE-L）组和高AGE评分（AGE-H）组。比较两组之间的人口统计学数据、实验室数据、脊髓最大受压情况、临床结局，如欧洲五维健康量表、颈部功能障碍指数和日本矫形外科学会评分，以及颈部、手臂、手部、腿部和足部疼痛的数字评定量表（NRS）评分。进行多元线性回归分析以评估AGE评分与下肢疼痛NRS评分之间的关联。
263例患者中，93例纳入本研究（AGE-L组41例，AGE-H组52例）。两组之间的人口统计学数据、实验室数据、脊髓最大受压情况和临床结局具有可比性。AGE-H组腿部和足部疼痛的NRS评分显著高于AGE-L组。多元线性回归分析显示，较高的AGE评分与DCM患者下肢更严重的疼痛显著相关。
AGEs的无创皮肤自发荧光可能是DCM患者下肢疼痛症状的有用生物标志物。
