非侵入性量測慢性腎臟病患的皮膚自體螢光標定晚期糖化終端產物的累積

晚期糖化終端產物 (AGEs) 的累積被認為是慢性腎臟病與糖尿病併發症的發病機制。而心血管疾病更是接受血液透析治療的末期腎衰竭患者最主要的死亡原因。皮膚自體螢光(Skin AF) 測量是一種非侵入性的方法來評估組織內AGEs 的累積。本研究的目的在建立台灣人Skin AF 之參考曲線並利用慢性腎臟病患者的臨床數據來佐證影響AGEs 累積的因素。有50 位健康受試者與92 位慢性腎臟病受試者(血液透析患者) 參與研究。我們採用AGE Reader 測量Skin AF 與進行血液常規檢查並記錄之。健康受試者 Skin AF 測量結果20-29 歲：1.35 ± 0.07 AU；30-39 歲：1.88 ± 0.22 AU；40- 49 歲：2.02 ± 0.27 AU；50-59 歲：2.22 ± 0.31 AU；60-69 歲：2.38 ± 0.37 AU； 70-79 歲：2.99 ± 0.65 AU；80-89 歲：3.60 ± 0.96 AU。它描述了年齡是一個影響Skin AF 的重要因素。在同一年齡層中黃種人Skin AF 高於白種人。它表示了測量Skin AF 會被膚色影響。慢性腎臟病受試者(包含糖尿病組與非糖尿病組) 臨床試驗的結果，也表示了糖化程度是影響AGEs 累積最主要的因素，其次是透析病程、白蛋白與三酸甘油酯等。

關鍵字

晚期糖化終端產物；慢性腎臟病；糖尿病；皮膚自體螢光；非侵入性；參考曲線

並列摘要

The accumulation of advanced glycation end products (AGEs) is thought to play a role in the pathogenesis of chronic complications of diabetes mellitus (DM) and renal failure. Cardiovascular diseases are the predominant causes of death in patients with end-stage renal disease undergoing hemodialysis. Skin autofluorescence (Skin AF) measurement is a non-invasive method for assessing accumulation of tissue AGEs. The aim of this study is to establish the reference curve of Skin AF for the Taiwan population and use the clinical data to determine the factors affecting the AGEs accumulation in chronic renal disease patients. 50 healthy subjects and 92 hemodialysis patients with chronic renal disease were enrolled in this study. The AGE Reader was employed to measure Skin AF and all the blood routine examination were recorded. The resultant mean values of Skin AF in healthy subjects are 1.35 ± 0.07 AU in 20-29 years; 1.88 ± 0.22 AU in 30-39 years; 2.02 ± 0.27 AU in 40-49 years; 2.22 ± 0.31 AU in 50-59 years; 2.38 ± 0.37 AU in 60-69 years; 2.99 ± 0.65 AU in 70-79 years; 3.60 ± 0.96 AU in 80-89 years. It depicts that the age is an important factor affecting the Skin AF. In the same age group the yellow race has higher level of Skin AF than the Caucasian. It shows that the Skin AF measurement is affected by skin color. It also results show that glycation levels is the strongest factor affecting the accumulation of AGEs in the chronic renal disease subjects (include with DM and without DM groups), and then dialysis duration, albumin and triglyceride.

並列關鍵字

Advanced glycation end products (AGEs) ； Chronic renal disease ； Diabetes mellitus (DM) ； Skin autofluorescence (Skin AF) ； Non-invasive ； Reference curve

參考文獻

[2] 蔡志忠、陳皓君，2002，生物體內梅納反應的化學與其抑制，CHEMISTRY (THE CHINESE CHEM. SOC., TAIPEI)，第60卷，第3期，頁335-349

[6] 王守玠、楊得政，2007，慢性腎臟病患者常見之心血管疾病，腎臟與透析，第19卷，第2期，頁89-94

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非侵入性量測慢性腎臟病患的皮膚自體螢光標定晚期糖化終端產物的累積

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