Sakata S, Takahashi M, Kushida K, Oikawa M, Hoshino H, Denda M, Inoue T
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Handa, Japan.
Nephron. 1998;78(3):260-5. doi: 10.1159/000044932.
Dialysis-related amyloidosis (DRA), such as destructive spondyloarthropathy (DSA) and carpal tunnel syndrome (CTS), occurs in the connective tissues of patients on long-term hemodialysis (HD). Recently, it was suggested that advanced glycation end products (AGEs) and beta2-microglobulin (beta2m) modified with AGEs are related to DRA. The aim of this study is to elucidate whether serum levels of pentosidine, which is an AGE, relate to the occurrence of DRA in patients with long-term HD. 127 end-stage renal failure patients, with DSA or CTS and undergoing HD, were examined. Serum pentosidine was measured by the HPLC method with column switching. Beta2m and intact parathyroid hormone (i-PTH) were measured. Pentosidine levels were significantly elevated in the DSA, CTS, and DRA groups (patients in the DRA group had either DSA and/or CTS). There were no significant differences in the beta2m and i-PTH levels between any group. The duration of HD did not correlate with either pentosidine or beta2m levels, but did with i-PTH. Receiver-operating characteristic (ROC) analysis was performed to examine the discriminatory ability of pentosidine, beta2m, and i-PTH for DRA. The area under the ROC curve was the greatest for pentosidine. Serum beta2m levels were not related with the occurrence of DRA. The fact that serum pentosidine was higher in DRA than in non-DRA indicates that it has potential as an indicator of the occurrence of DRA in long-term HD patients.
透析相关淀粉样变性（DRA），如破坏性脊椎关节病（DSA）和腕管综合征（CTS），发生在长期血液透析（HD）患者的结缔组织中。最近，有人提出晚期糖基化终产物（AGEs）以及经AGEs修饰的β2微球蛋白（β2m）与DRA有关。本研究的目的是阐明作为一种AGE的戊糖苷血清水平是否与长期HD患者DRA的发生有关。对127例患有DSA或CTS且正在接受HD的终末期肾衰竭患者进行了检查。采用柱切换高效液相色谱法测定血清戊糖苷。测定了β2m和完整甲状旁腺激素（i-PTH）。DSA组、CTS组和DRA组（DRA组患者患有DSA和/或CTS）的戊糖苷水平显著升高。各组之间的β2m和i-PTH水平无显著差异。HD的持续时间与戊糖苷或β2m水平均无相关性，但与i-PTH相关。进行了受试者操作特征（ROC）分析，以检验戊糖苷、β2m和i-PTH对DRA的鉴别能力。戊糖苷的ROC曲线下面积最大。血清β2m水平与DRA的发生无关。DRA患者血清戊糖苷高于非DRA患者，这一事实表明它有可能作为长期HD患者DRA发生的指标。
