Decreased serum carnitine is independently correlated with increased tissue accumulation levels of advanced glycation end products in haemodialysis patients
Decreased serum carnitine is independently correlated with increased tissue accumulation levels of advanced glycation end products in haemodialysis patients
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DOI：
10.1111/j.1440-1797.2012.01642.x
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发表时间：
2012-11-01
期刊：
影响因子：
2.5
通讯作者：
Okuda, Seiya
中科院分区：
文献类型：
--
作者：
Adachi, Takeki;Fukami, Kei;Okuda, Seiya
目的：越来越多的证据表明，晚期糖基化终末产物（AGE）在血液透析（HD）患者的心血管疾病（CVD）中发挥作用。肉毒碱缺乏症是经常观察到血液透析患者，这也可能有助于心血管疾病。在这项研究中，我们研究是否肉毒碱缺乏症是独立相关的增加组织积累水平的AGE在HD patients.Methods：一百二十九HD患者进行了测定血液化学，包括血清水平的肉毒碱。结果：HD患者血清肉毒碱水平显著低于健康对照组，而皮肤AGE水平显著高于健康对照组（P < 0.001）。在单因素分析中，β（2）-微球蛋白（β（2）-MG）和肉毒碱（逆）与皮肤AGE水平相关。多元逐步回归分析显示，肉毒碱水平是皮肤AGE水平的独立决定因素之一（P = 0.024）。当β 2-MG校正的皮肤AGE水平按血清肉毒碱水平分层时，观察到统计学显著性和剂量-反应关系（P = 0.043）。结论：血透患者血清肉毒碱水平降低与皮肤AGE水平升高独立相关。由于据报道肉毒碱在体外抑制AGE的形成，我们的研究表明，补充肉毒碱可能是一个治疗目标，以防止组织AGE的积累，并随后降低心血管疾病的风险在HD患者。
Aim: There is accumulating evidence that advanced glycation end products (AGE) play a role in cardiovascular disease (CVD) in patients with haemodialysis (HD). Carnitine deficiency is frequently observed in HD patients, which may also contribute to CVD. In this study, we examined whether carnitine deficiency was independently associated with increased tissue accumulation levels of AGE in HD patients.Methods: One hundred and twenty-nine HD patients underwent determinations of blood chemistries including serum level of carnitine. Tissue AGE levels were evaluated by measuring skin autofluorescence with an AGE-reader.Results: Serum carnitine levels were significantly lower, while skin AGE levels were significantly higher in HD patients compared with healthy controls (P < 0.001). In univariate analysis, beta(2)-microglobulin (beta(2)-MG) and carnitine (inversely) were correlated with skin AGE levels. Multiple stepwise regression analysis revealed that carnitine levels were one of the independent determinants of skin AGE levels (P = 0.024). When beta(2)-MG-adjusted skin AGE levels were stratified by serum carnitine levels, a statistical significance and dose-response relationship were observed (P = 0.043). Furthermore, skin AGE levels were one of the independent determinants of serum carnitine levels as well (P = 0.012).Conclusion: The present study demonstrated that decreased carnitine levels were independently associated with increased skin AGE levels in HD patients. Since carnitine is reported to inhibit the formation of AGE in vitro, our study suggests that supplementation of carnitine may be a therapeutic target for preventing the accumulation of tissue AGE and subsequently reducing the risk of CVD in HD patients.