Skin Autofluorescence Predicts Cardiovascular Mortality in Patients on Chronic Hemodialysis

Abstract

Tissue accumulation of advanced glycation end products (AGE) is thought to contribute to the progression of cardiovascular disease (CVD). Skin autofluorescence, a non‐invasive measure of AGE accumulation using autofluorescence of the skin under ultraviolet light, has been reported to be an independent predictor of mortality associated with CVD in Caucasian patients on chronic hemodialysis. The aim of this study was to assess the predictive value of skin autofluorescence on all‐cause and cardiovascular mortality in non‐Caucasian (Japanese) patients on chronic hemodialysis. Baseline skin autofluorescence was measured with an autofluorescence reader in 128 non‐Caucasian (Japanese) patients on chronic hemodialysis. All‐cause and cardiovascular mortality was monitored prospectively during a period of 6 years. During the follow‐up period, 42 of the 128 patients died; 19 of those patients died of CVD. Skin autofluorescence did not have a significant effect on all‐cause mortality. However, age, carotid artery intima‐media thickness (IMT), serum albumin, high‐sensitivity C‐reactive protein (hsCRP), skin autofluorescence and pre‐existing CVD were significantly correlated with cardiovascular mortality. Multivariate Cox regression analysis showed skin autofluorescence (adjusted hazard ratio [HR] 3.97; 95% confidence interval [CI]1.67–9.43), serum albumin (adjusted HR 0.05; 95% CI 0.01–0.32), and hsCRP (adjusted HR 1.55; 95% CI 1.18–2.05) to be independent predictors of cardiovascular mortality. The present study suggests that skin autofluorescence is an independent predictor of cardiovascular mortality in non‐Caucasian (Japanese) patients on chronic hemodialysis.

Skin Autofluorescence–Indicated Advanced Glycation End Products as Predictors of Cardiovascular and All‐Cause Mortality in High‐Risk Subjects: A Systematic Review and Meta‐analysis

“…Of the 56 full‐text articles reviewed, only 10 studies25, 26, 27, 28, 29, 30, 31, 32, 33, 34 met the eligibility criteria (Figure 1). Seven studies25, 27, 28, 30, 33, 34 quantified the risk for all‐cause mortality, and 8 samples from 7 studies25, 26, 27, 29, 32, 34 quantified the risk for cardiovascular mortality.…”

“…Seven studies25, 27, 28, 30, 33, 34 quantified the risk for all‐cause mortality, and 8 samples from 7 studies25, 26, 27, 29, 32, 34 quantified the risk for cardiovascular mortality. The studies were conducted in 4 European countries25, 26, 27, 28, 30, 31, 32, 33, 34 and 1 Asian country 29. The reports were published between 2005 and 2015 (Table 1).…”

“…The studies included patients with renal disease,25, 27, 28, 29, 31, 33, 34 peripheral artery disease,26 and diabetes mellitus 30, 32. The percentage of male participants ranged from 39.3% to 73.0%, and the percentage of current smokers ranged from 10.0% to 50.0%.…”

“…The percentage of male participants ranged from 39.3% to 73.0%, and the percentage of current smokers ranged from 10.0% to 50.0%. Most studies included a normal weight population,25, 28, 29, 31, 32 and only 3 included an overweight population 26, 27, 31. The prevalence of hypertension ranged from 18.0% to 91.0%, and the prevalence of preexisting CVD ranged from 29.0% to 50.0%.…”

A bőr-autofluoreszcencia és a konvencionális glykaemiás markerek kapcsolata diabeteses betegekben

“…A cardiovascularis mortalitás és a SAF közötti összefüggést hemodializált betegcsoportban 6 éves japán vizsgálatban is megerősítették [31]. A hemodialízis előtt és után mérhető SAF-szint egyetlen kezelést tekintve nem mutatott változást, a plazma autofl uoreszcencia ugyanakkor a dialízis után az eltávolított fl uoreszcens molekulák miatt csökkent [32].…”