PDF(Pubmed)
Abstract：
UNASSIGNED: Elevated skin autofluorescence (SAF), a measure of tissue accumulation of advanced glycation end products (AGEs), is a strong predictor of all-cause and cardiovascular mortality in the hemodialysis population. However, prospective studies investigating the association between changes in SAF over time and mortality are scarce. We therefore aimed to investigate the prognostic value of SAF trend for predicting mortality in a hemodialysis population.
UNASSIGNED: We enrolled 120 patients on hemodialysis in a 5-year observational, prospective study. SAF was measured at baseline, 3, 6, 9, 12, and 24 months. Rate of change in SAF (i.e., SAF trend) was calculated using linear regression. Time to event was the number of days from baseline to death, kidney transplantation, or March 31, 2022.
UNASSIGNED: Mean age, mean baseline SAF, and median SAF trend were 65 ± 14 years, 3.4 ± 0.9 arbitrary units (AU), and an increase of 0.1 (-0.1 to 0.4) AU/yr, respectively. Median observation time was 42 months, during which 59 participants (49%) died. Univariable analysis identified age, history of smoking, lower serum albumin, higher baseline SAF, and increase in SAF as significant predictors of higher mortality. In multivariable analysis, higher baseline SAF (hazard ratio: 1.45; 95% confidence interval: 1.08-1.94; P = 0.01) and increasing SAF trend (2.37 [1.43-3.93]; P < 0.001) were independent predictors of increased mortality.
UNASSIGNED: An increasing SAF trend and higher baseline SAF were independent predictors of all-cause mortality in this hemodialysis population, suggesting that monitoring of SAF may have clinical utility. Strategies to improve outcomes by reducing or preventing the increase in SAF should now be investigated in prospective studies.
UNASSIGNED: We enrolled 120 patients on hemodialysis in a 5-year observational, prospective study. SAF was measured at baseline, 3, 6, 9, 12, and 24 months. Rate of change in SAF (i.e., SAF trend) was calculated using linear regression. Time to event was the number of days from baseline to death, kidney transplantation, or March 31, 2022.
UNASSIGNED: Mean age, mean baseline SAF, and median SAF trend were 65 ± 14 years, 3.4 ± 0.9 arbitrary units (AU), and an increase of 0.1 (-0.1 to 0.4) AU/yr, respectively. Median observation time was 42 months, during which 59 participants (49%) died. Univariable analysis identified age, history of smoking, lower serum albumin, higher baseline SAF, and increase in SAF as significant predictors of higher mortality. In multivariable analysis, higher baseline SAF (hazard ratio: 1.45; 95% confidence interval: 1.08-1.94; P = 0.01) and increasing SAF trend (2.37 [1.43-3.93]; P < 0.001) were independent predictors of increased mortality.
UNASSIGNED: An increasing SAF trend and higher baseline SAF were independent predictors of all-cause mortality in this hemodialysis population, suggesting that monitoring of SAF may have clinical utility. Strategies to improve outcomes by reducing or preventing the increase in SAF should now be investigated in prospective studies.
摘要：
■皮肤自发荧光（SAF）升高，晚期糖基化终产物（AGEs）的组织积累的量度，是血液透析人群全因死亡率和心血管死亡率的有力预测指标。然而,缺乏调查SAF随时间变化与死亡率之间关系的前瞻性研究.因此，我们旨在研究SAF趋势对预测血液透析人群死亡率的预后价值。
■我们在5年的观察中纳入了120例血液透析患者，前瞻性研究。在基线测量SAF，3、6、9、12和24个月。SAF的变化率(即，SAF趋势)使用线性回归计算。事件发生时间是从基线到死亡的天数，肾移植,或2022年3月31日。
■平均年龄，平均基线SAF，SAF趋势中位数为65±14年，3.4±0.9任意单位（AU），和增加0.1(-0.1到0.4)AU/yr，分别。中位观察时间为42个月,59名参与者（49%）死亡。单变量分析确定年龄，吸烟史,低血清白蛋白，较高的基线SAF，SAF的增加是较高死亡率的重要预测因素。在多变量分析中，较高的基线SAF(风险比:1.45;95%置信区间:1.08~1.94;P=0.01)和增加的SAF趋势(2.37[1.43~3.93];P<0.001)是死亡率增加的独立预测因素.
■增加的SAF趋势和较高的基线SAF是该血液透析人群全因死亡率的独立预测因子，这表明监测SAF可能具有临床实用性。现在应该在前瞻性研究中研究通过减少或防止SAF增加来改善结果的策略。
■我们在5年的观察中纳入了120例血液透析患者，前瞻性研究。在基线测量SAF，3、6、9、12和24个月。SAF的变化率(即，SAF趋势)使用线性回归计算。事件发生时间是从基线到死亡的天数，肾移植,或2022年3月31日。
■平均年龄，平均基线SAF，SAF趋势中位数为65±14年，3.4±0.9任意单位（AU），和增加0.1(-0.1到0.4)AU/yr，分别。中位观察时间为42个月,59名参与者（49%）死亡。单变量分析确定年龄，吸烟史,低血清白蛋白，较高的基线SAF，SAF的增加是较高死亡率的重要预测因素。在多变量分析中，较高的基线SAF(风险比:1.45;95%置信区间:1.08~1.94;P=0.01)和增加的SAF趋势(2.37[1.43~3.93];P<0.001)是死亡率增加的独立预测因素.
■增加的SAF趋势和较高的基线SAF是该血液透析人群全因死亡率的独立预测因子，这表明监测SAF可能具有临床实用性。现在应该在前瞻性研究中研究通过减少或防止SAF增加来改善结果的策略。
