title: Skin Autofluorescence Is Associated with Endothelial Dysfunction in Uremic Subjects on Hemodialysis.
abstract: BACKGROUND
  Elevated levels of advanced glycation end products (AGEs) within tissues may contribute to endothelial dysfunction, an early indicator of atherosclerosis. We aimed to investigate whether levels of skin AGEs could be a useful marker to predict endothelial dysfunction in uremic subjects on hemodialysis.
  
  
  RESULTS
  One hundred and nineteen uremic patients on hemodialysis and 57 control subjects with moderate-to-high cardiovascular risk factors and without chronic kidney disease (CKD) were enrolled. We used ultrasound to measure flow-mediated vasodilation (FMD). An AGE reader measured skin autoflurorescence (AF). We then compared differences in FMD and skin AF values between the two groups. The uremic subjects had significantly higher levels of skin AF (3.47±0.76 AU vs. 2.21±0.45 arbitrary units; P<0.01) and significantly lower levels of FMD (4.79%±1.88% vs. 7.19%±2.17%; P<0.01) than the non-CKD subjects. After adjusting for all potential covariates, we found that skin AF level independently predicted FMD in both the hemodialysis and the non-CKD groups. In the hemodialysis group, skin AF ≥ 3.05 arbitrary units predicted abnormal FMD at a sensitivity of 87.9% and a specificity of 78.6% (P<0.01).
  
  
  CONCLUSIONS
  Skin AF could be a useful marker to predict endothelial dysfunction in uremic subjects on hemodialysis.
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Division of Cardiology, Department of Internal Medicine, Taichung Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Taichung, Taiwan.|Cardiovascular research laboratory, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chun-Cheng
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Division of Cardiothoracic surgery, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan.
authors.forename: Yao-Chang
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.|Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan.
authors.forename: Guei-Jane
authors.initials: GJ
authors.lastname: Wang
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Ming-Yi
authors.initials: MY
authors.lastname: Shen
authors.affiliation: Department of Biomedical Engineering, Chun Yuan Christian University, Taoyuan, Taiwan.
authors.forename: Yen-Lin
authors.initials: YL
authors.lastname: Chang
authors.affiliation: Formosan Blood Purification Foundation, Taipei, Taiwan.
authors.forename: Show-Yih
authors.initials: SY
authors.lastname: Liou
authors.affiliation: Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.|Cardiovascular research laboratory, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000209:etiology / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D017127:Glycation End Products, Advanced; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D012867:Skin / Q000378:metabolism*; D014664:Vasodilation / Q000502:physiology
chemical_list: D015415:Biomarkers; D017127:Glycation End Products, Advanced
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