Abstract

Skin autofluorescence (AF) has been validated as a tool for estimating tissue advanced glycation end products (AGEs) accumulation and predicting long-term cardiovascular outcomes. However, whether measurements of skin AF could predict renal function decline remains controversial. From April, 2014 to April, 2015, we enrolled 245 subjects with at least two conventional risk factors for coronary artery disease (CAD). All were measured for body height and weight, blood pressure, plasma creatinine level, and skin AF at the start of the study. Baseline demographics and laboratory tests data were obtained by chart reviews and patient interviews. Serial plasma creatinine levels were followed regularly every 6–12 months for 2 years. In a stepwise multivariate linear regression analysis, skin AF, was an independent factor for predicting the relative renal function decline rate after adjustment of multiple covariates (ß = -0.036±0.016; p = 0.03). Subgroups analysis revealed that skin AF was a significant factor for relative renal function decline rate in subgroups of age < 65 years (ß = -0.068±0.024; p = 0.02), male sex (ß = -0.053±0.016; p< 0.01), body mass index≧25 Kg/m2(ß = -0.042±0.021; p = 0.04), and estimated glomerular filtration rate ≥ 60 ml/min/1.73m2(ß = -0.043±0.020; p = 0.04). However, only an interaction between skin AF and age attained significance (p for interaction = 0.04). Skin AF is a useful predictor for renal function decline in patients at increased risk of CAD.

Highlights

  • Advanced glycation end products (AGEs) is formed by nonenzymatic binding between a reducing suger and an amine group from a protein, lipid, or amino acid, which is called the “Maillard reaction”[1]

  • After adjustment for age, sex, diastolic blood pressure (DBP), pulse pressure (PP), body mass index (BMI), diabetes mellitus (DM), glycohemoglobin, Hypertension, hyperlipidemia, antiplatelets, ACEIs/ARBs, statins, and non-steroidal anti-inflammatory drugs (NSAIDs), skin AF and NSAIDs remained independent factors for predicting rapid renal function decline (Table 2)

  • Proposed mechanisms of skin AF as a tool for predicting renal function decline In our study, we demonstrated that skin AF could predict renal function decline in a 2-year follow-up period in patients at increased risk of coronary artery disease (CAD)

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Summary

Introduction

Advanced glycation end products (AGEs) is formed by nonenzymatic binding between a reducing suger and an amine group from a protein, lipid, or amino acid, which is called the “Maillard reaction”[1]. AGEs formation requires hyperglycemia and increased oxidative stress. Enhanced AGE formation may accumulate in the skin, cardiac, renal, vascular, and neurological systems. The pathological significance of AGEs accumulation could be systemic[1].

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