Accumulation of tissue advanced glycation end products correlated with glucose exposure dose and associated with cardiovascular morbidity in patients on peritoneal dialysis

被引：52

作者：

Jiang, Jianping ^{[1
]}

Chen, Pingyan ^{[2
]}

Chen, Jianghua ^{[3
]}

Yu, Xueqing ^{[4
]}

Xie, Di ^{[1
]}

Mei, Changlin ^{[5
]}

Xiong, Fei ^{[6
]}

Shi, Wei ^{[7
]}

Zhou, Wei ^{[8
]}

Liu, Xusheng ^{[9
]}

Sun, Shiren ^{[10
]}

Zhang, Ping ^{[3
]}

Yang, Xiao ^{[4
]}

Zhang, Yixiang ^{[5
]}

Zhang, Yanmin ^{[6
]}

Liang, Xinling ^{[7
]}

Zhang, Zhimin ^{[8
]}

Lin, Qizhan ^{[9
]}

Yu, Yan ^{[10
]}

Miyata, Toshio ^{[11
]}

Tian, Jianwei ^{[1
]}

Liang, Min ^{[1
]}

Luo, Weihong ^{[1
]}

Xu, Xin ^{[1
]}

Hou, Fanfan ^{[1
]}

机构：

[1] So Med Univ, Nanfang Hosp, Div Nephrol, Guangzhou, Guangdong, Peoples R China

[2] So Med Univ, Sch Publ Hlth & Trop Med, Dept Biostat, Guangzhou, Guangdong, Peoples R China

[3] Zhejiang Univ, Coll Med, Affiliated Hosp 1, Div Nephrol, Hangzhou 310003, Zhejiang, Peoples R China

[4] Sun Yat Sen Univ, Affiliated Hosp 1, Div Nephrol, Guangzhou 510275, Guangdong, Peoples R China

[5] Secondary Mil Med Univ, Changzheng Hosp, Div Nephrol, Shanghai, Peoples R China

[6] First Peoples Hosp, Div Nephrol, Wuhan, Peoples R China

[7] Guangdong Gen Hosp, Div Nephrol, Guangzhou, Guangdong, Peoples R China

[8] 309th Hosp Peoples Liberat Army, Div Nephrol, Beijing, Peoples R China

[9] Guangdong Prov Hosp Tradit Chinese Med, Div Nephrol, Guangzhou, Guangdong, Peoples R China

[10] Fourth Mil Med Univ, Xijing Hosp, Div Nephrol, Xian 710032, Peoples R China

[11] Tohoku Univ, Grad Sch Med, United Ctr Adv Res & Translat Med, Sendai, Miyagi 980, Japan

来源：

ATHEROSCLEROSIS | 2012年 / 224卷 / 01期

关键词：

Advanced glycation end products; Skin autofluorescence; Peritoneal dialysis; Glucose; Cardiovascular morbidity; CHRONIC KIDNEY-DISEASE; STAGE RENAL-DISEASE; SKIN-AUTOFLUORESCENCE; HEMODIALYSIS-PATIENTS; OXIDATIVE STRESS; DEGRADATION-PRODUCTS; MORTALITY; RISK; COMPLICATIONS; MEMBRANE;

D O I：

10.1016/j.atherosclerosis.2012.06.022

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: Accumulation of tissue advanced glycation end products (AGEs) is a marker of cumulative glycemic and/or oxidative stress. Cutaneous AGEs levels measured by skin autofluorescence correlate well with cardiovascular outcomes in diabetes and hemodialysis (HD) patients. The present study aimed to compare tissue AGEs levels with peritoneal dialysis (PD) and HD patients and to evaluate the relationship between skin autofluorescence and cardiovascular morbidity in patients on PD. Methods: A total of 2388 maintenance dialysis patients (613 PD and 1775 HD) were enrolled in this cross-sectional study. Skin autofluorescence was measured non-invasively with an autofluorescence reader. Cardiovascular morbidity was defined as clinically diagnosed ischemic heart disease, heart failure, stroke or peripheral vascular disease from initiation of dialysis. Results: More than 90% of patients on both PD and HD had met current dialysis adequacy targets. Compared to HD group, PD patients receiving conventional glucose-containing dialyzate had significantly higher skin autofluorescence values in each category of age and dialysis duration, irrespective of the presence or absence of diabetes. In PD patients, skin autofluorescence values were strongly correlated with the duration of PD and glucose exposure dose and independently associated with cardiovascular morbidity. Multivariate analysis revealed that glucose exposure dose and skin autofluorescence were the strongest risk factors for cardiovascular morbidity in PD patients after adjustment by age, gender, and other classic- or uremic-related risk factors. Conclusions: Accumulation of tissue AGEs provides a potential link between PD exposure of metabolic stress and progression of cardiovascular disease in patients on PD. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

引用

页码：187 / 194

页数：8

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