Skin-autofluorescence, a measure of tissue advanced glycation end-products (AGEs), is related to diastolic function in dialysis patients.
BACKGROUND
Diastolic dysfunction is a frequent cause of heart failure, particularly in dialysis patients. Advanced glycation end-products (AGEs) are increased in dialysis patients and are suggested to play a role in the development of diastolic dysfunction. The aim of our study was to assess whether AGE accumulation in dialysis patients is related to the presence of diastolic dysfunction.


RESULTS
Data were analyzed from 43 dialysis patients, age 58 +/- 15 years, of whom 65% were male. Diastolic function was assessed using tissue velocity imaging (TVI) on echocardiography. Tissue AGE accumulation was measured using a validated skin-autofluorescence (skin-AF) reader. Plasma N(epsilon)-(carboxymethyl)lysine (CML) and N(epsilon)-(carboxyethyl)lysine (CEL) were measured by stable-isotope-dilution tandem mass spectrometry. Plasma pentosidine was measured by high-performance liquid chromatography. Skin-AF correlated with mean E' (r = -0.51, P < .001), E/A ratio (r = -0.39, P = .014), and E/E' (r = 0.38, P = .019). Plasma AGEs were not significantly associated with diastolic function. Multivariable linear regression analysis revealed that 54% of the variance of average E' was explained by age (P = .007), dialysis type (P = 0.016), and skin-AF (P = .013).


CONCLUSIONS
Tissue AGEs measured as skin-AF, but not plasma AGE levels, were related to diastolic function in dialysis patients. Although this may support the concept that tissue AGEs explain part of the increased prevalence of diastolic dysfunction in these patients, the ambiguous relation between plasma and tissue AGEs needs further exploring.
Hartog
Jasper W L
JW
Department of Cardiology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
Hummel
Yoran M
YM
Voors
Adriaan A
AA
Schalkwijk
Casper G
CG
Miyata
Toshio
T
Huisman
Roel M
RM
Smit
Andries J
AJ
Van Veldhuisen
Dirk J
DJ
D000367:Age Factors; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics; D002306:Cardiac Volume / Q000502:physiology; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D004452:Echocardiography; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D005260:Female; D005453:Fluorescence; D017127:Glycation End Products, Advanced / Q000032:analysis* / Q000097:blood / Q000493:pharmacokinetics; D054144:Heart Failure, Diastolic / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D006435:Renal Dialysis / Q000145:classification; D012307:Risk Factors; D012737:Sex Factors; D012867:Skin / Q000378:metabolism* / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D053719:Tandem Mass Spectrometry; D018754:Ventricular Dysfunction / Q000209:etiology* / Q000503:physiopathology; D016276:Ventricular Function / Q000502:physiology; D017725:Ventricular Pressure / Q000502:physiology
D017127:Glycation End Products, Advanced; C117804:ethyl lysine; C048496:N(6)-carboxymethyllysine; D001120:Arginine; C062187:pentosidine; D008239:Lysine