PDF(Pubmed)
Abstract：
It has previously been unclear whether the accumulation of advanced glycation end products, which can be measured using skin autofluorescence (SAF), has a significant role in diabetic kidney disease (DKD), including glomerular injury and tubular injury. This study was therefore carried out to determine whether SAF correlates with the progression of DKD in people with type 2 diabetes (T2D). In 350 Japanese people with T2D, SAF values were measured using an AGE Reader®, and both urine albumin-to-creatinine ratio (uACR), as a biomarker of glomerular injury, and urine liver-type fatty acid-binding protein (uLFABP)-to-creatinine ratio (uL-FABPCR), as a biomarker of tubular injury, were estimated as indices of the severity of DKD. Significant associations of SAF with uACR (p < 0.01), log-transformed uACR (p < 0.001), uL-FABPCR (p < 0.001), and log-transformed uL-FABPCR (p < 0.001) were found through a simple linear regression analysis. Although SAF was positively associated with increasing uL-FABPCR (p < 0.05) and increasing log-transformed uL-FABPCR (p < 0.05), SAF had no association with increasing uACR or log-transformed uACR after adjusting for clinical confounding factors. In addition, the annual change in SAF showed a significant positive correlation with annual change in uL-FABPCR regardless of confounding factors (p = 0.026). In conclusion, SAF is positively correlated with uL-FABP but not with uACR in people with T2D. Thus, there is a possibility that SAF can serve as a novel predictor for the development of diabetic tubular injury.
摘要：
以前还不清楚晚期糖基化终产物的积累，可以使用皮肤自发荧光（SAF）进行测量，在糖尿病肾病（DKD）中具有重要作用，包括肾小球损伤和肾小管损伤。因此，进行这项研究以确定SAF是否与2型糖尿病（T2D）患者的DKD进展相关。在350名患有T2D的日本人中，使用AGEReader®测量SAF值，和尿白蛋白肌酐比值（uACR），作为肾小球损伤的生物标志物，和尿肝型脂肪酸结合蛋白（uLFABP）-肌酐比值（uL-FABPCR），作为肾小管损伤的生物标志物，被估计为DKD严重程度的指标。SAF与uACR显著相关(p<0.01)，对数变换的uACR(p<0.001)，uL-FABPCR（p<0.001），和对数转化的uL-FABPCR(p<0.001)通过简单的线性回归分析发现。尽管SAF与uL-FABPCR增加（p<0.05）和log转化的uL-FABPCR增加（p<0.05）呈正相关，在调整临床混杂因素后，SAF与uACR或对数转化uACR的增加无关。此外,与混杂因素无关,SAF的年度变化与uL-FABPCR的年度变化呈显著正相关(p=0.026).总之,在T2D患者中，SAF与uL-FABP呈正相关，但与uACR无关。因此，SAF有可能作为糖尿病性肾小管损伤发展的新预测因子.
