Skin autofluorescence and subclinical atherosclerosis in mild to moderate chronic kidney disease: a case-control study

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2017Author
Arroyo, David
López Cano, Carolina
Suggested citation
Sánchez Peña, Enric;
Betriu i Bars, M. Àngels;
Arroyo, David;
López Cano, Carolina;
Hernández García, Marta;
Rius, Ferran;
...
Lecube Torelló, Albert.
(2017)
.
Skin autofluorescence and subclinical atherosclerosis in mild to moderate chronic kidney disease: a case-control study.
Plos One, 2017, vol. 12, núm. 1, e0170778.
https://doi.org/10.1371/journal.pone.0170778.
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Show full item recordAbstract
Advanced glycation end-products (AGEs) are increased and predict mortality in patients
with chronic kidney disease (CKD) who are undergoing hemodialysis, irrespective of the
presence of type 2 diabetes. However, little information exits about the relationship between
AGEs and subclinical atherosclerosis at the early stages of CKD. A case-control study was
performed including 87 patients with mild-to-moderate stages of CKD (glomerular filtration
rate from 89 to 30 ml/min/per 1.73m2) and 87 non-diabetic non-CKD subjects matched by
age, gender, body mass index, and waist circumference. Skin autofluorescence (AF), a
non-invasive assessment of AGEs, was measured. The presence of atheromatous disease
in carotid and femoral arteries was evaluated using vascular ultrasound, and vascular age
and SCORE risk were estimated. Patients with mild-to-moderate stages of CKD showed an
increase in skin AF compared with control subjects (2.5±0.6 vs. 2.2±0.4 AU, p<0.001). A
skin AF value >2.0 AU was accompanied by a 3-fold increased risk of detecting the presence
of an atheromathous plaque (OR 3.0, 95% CI 1.4±6.5, p = 0.006). When vascular age
was assessed through skin AF, subjects with CKD were almost 12 years older than control
subjects (70.3±25.5 vs. 58.5±20.2 years, p = 0.001). Skin AF was negatively correlated with
glomerular filtration rate (r = -0.354, p<0.001) and LDL-cholesterol (r = -0.269, p = 0.001),
and positively correlated with age (r = 0.472, p<0.001), pulse pressure (r = 0.238, p =
0.002), and SCORE risk (r = 0.451, p<0.001). A stepwise multivariate regression analysis
showed that age and glomerular filtration rate independently predicted skin AF (R2 = 0.289,
p<0.001). Skin AF is elevated in patients with mild-to-moderate CKD compared with control
subjects. This finding may be independently associated with the glomerular filtration rate
and the presence of subclinical atheromatous disease. Therefore, the use of skin AF may
help to accurately evaluate the real cardiovascular risk at the early stages of CKD.
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Plos One, 2017, vol. 12, núm. 1, e0170778European research projects
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