Ronde, M.G. (Martijn) (2015) Lokale verschillen in oxidatieve stress als oorzaak van lokaal verhoogde AGEs bij patiënten met PVL. thesis, Medicine.
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Abstract
Objective Advanced glycation endproducts (AGEs) are sugar-modified proteins and are formed through nonenzymatic glycation and oxidation. AGEs contribute in the development of atherosclerosis in two ways. First through the formation of crosslinks between the elastine and collagen, leading to stiffening of the arteries. The second way in which AGEs contribute to atherosclerotic process is by binding at the receptor for AGE (RAGE), stimulating inflammatory and cellular stress. Using the fluorescent properties of AGEs, they can noninvasively be measured by the so-called AGE-reader that has been developed at the UMCG. Recently an increased skin autofluorescence (SAF) at the legs compared to the arms has been reported in patients with peripheral arterial disease (PAD). Regional and local increased oxidative stress, caused by a difference in blood flow of the extremities of PAD patient might be the cause. In this study we investigate if the higher SAF in the legs of PAD-patients is indeed caused by an locally increased oxidative stress. We will investigate is by measuring and comparing the SAF of the arms and legs in patients without PAD. Patients without PAD do not experience local problems in blood flow and therefore do not experiences locally increased oxidative stress. Therefore we expect to find no difference in SAF between the arms and legs in patients without PAD. Method and results We performed a cross-sectional cohord study with 152 patients, 89 with proven PAD (PAD-group) and 61 without PAD (control group). The presence of cardiovascular risk factors and the use of medication were analyzed. SAF was measured with the AGE-reader. With the Wilcoxon signed ranks test we compared the SAF of right leg with the SAF of the right arm and the SAF of the left leg with the SAF of the left arm in the control group. We found no differences [p=0,066 and p=0,244]. Either there was no difference in SAF between the left and the right arm and between the left and the right leg in the control group, respectively [p=0,130 and p=0,237]. Also for the PVL patients we found no difference in SAF between the left and the right arm and between the left and the right leg, respectively [p=0,553 and p=0,289]. Spearman correlations of the SAF between the right arm and the right leg and between the left arm and the left leg were both high for the patients in the control group, respectively [r=0,847 and r=0,821]. In the PAD-group Spearman correlations of the SAF between the right arm and the right leg and between the left arm and the left leg were moderate [r=0,555 and r=0,618]. Spearman correlations between the left ankle-brachial index (ABI) and the difference in SAF between the left leg and arm were negative, no correlation was found. However a Spearman correlation between the right ABI and the difference in SAF between the right leg and arm was found [r=-0,200]. Conclusion This study shows that there is no difference in SAF between the arms and legs in patients without PAD. In a previous study we reported a difference in SAF between the arms and the legs of PAD-patients. Because PAD-patients experience enhanced oxidative stress in their legs compared with the arms, in contrast to patients without PAD, we conclude that the difference in SAF between the arms and legs found in the previous study is caused by locally increased oxidative stress, possibly due to local problems in blood flow.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Lefrandt, Dr. J.D. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/724 |
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