| Abstrakt: |
The objectives of the study was to measure the rate of accumulation of different advanced glycation endproducts in the skin of diabetic hemodialysis patients over a period of one year and to find the factors that influence this process. Twenty-two diabetic hemodialysis patients were enrolled in this study. Skin biopsies were taken from 14 patients twice with an interval of one year. The amount of pentosidine, carboxymethyl-lysine and carboxyethyllysine in the biopsies was measured biochemically. Pentosidine levels in the tissue biopsies were measured by high performance liquid chromatography. Detection of pentosidine was based on its own fluorescence characteristics using fluorimetric detection. Carboxymethyl-lysine and carboxyethyl-lysine were determined by stable-isotopedilution liquid chromatography tandem mass spectrometry. Carboxymethyl-lysine and carboxyethyl-lysine were liberated from plasma proteins by acid hydrolysis after addition of deuterated carboxymethyl-lysine and carboxyethyl-lysine as internal standards. Skin autofluorescence was measured non-invasively to determine the advanced glycation end-products accumulation in the skin. Dietary records from the hemodialysis patients were obtained to assess the advanced glycation end-products, calorie and protein intake. Furthermore, body mass index, as a measure of nutritional state, was obtained. The pentosidine, carboxymethyl-lysine and carboxyethyl-lysine content of the biopsies correlated with skin autofluorescence, but all four variables were not significantly different between the two time points. We found that the independent predictors of the one year increase of pentosidine were: one year increase of skin autofluoprescence and the skin autofluorescence value at the first time point. The independent predictors of the one year increase of carboxymethyl-lysine were: onе year increase of skin autofluorescence, the skin autofluorescence value at the second time point and the 4th quintile of body mass index. The independent predictors of the one year increase of carboxyethyl-lysine L were the one year increase of skin autofluorescence and the 4th quintile of body mass index. Neither the amount of advanced glycation end-products measured in the skin biopsies nor their one year increase correlated with the intake of advanced glycation endproducts, calories and proteins. The rate of skin advanced glycation end-products accumulation is independently associated with the increase of skin autofluorescence and body mass index. To my surprise I did not note a significant change in level of skin advanced glycation end-products as determined from the biopsies and skin autoflourescence between the measurements at one year interval in our group of diabetic hemodialysis patients. This can be due to the small size of the group. [ABSTRACT FROM AUTHOR] |
