Buisman, M.J. (2019) The relationship between skin autofluorescence and arterial stiffness in patients with occluding and dilating vascular disease. thesis, Medicine.
Full text available on request.Abstract
Background Advanced glycation end products (AGEs) have been implicated in the pathogenesis of both peripheral artery disease (PAD) and abdominal aortic aneurysms (AAA). AGEs are associated with vascular stiffness and can be measured non-invasively with skin autofluorescence (SAF) with the AGE-reader. Diabetes mellitus (DM) aggravates PAD but protects against development of AAA. The ARTERY study was designed to compare skin, tissue and vascular AGEs in patients with PAD and AAA with and without DM. SAF has been shown to be positively associated with vascular stiffness in patients with coronary artery disease, end stage renal failure and diabetes type 1.Therefore, this exploratory study aimed to explore the relationship between arterial stiffness and SAF in patients with PAD and AAA. Secondary aims were to evaluate the relationship of SAF with atherosclerotic burden and to evaluate known determinants of SAF and arterial stiffness in this population. Method An interim analysis of the ARTERY was performed in 29 patients with either PAD (n=13), AAA (n=7) or PAD and AAA (n=9). Arterial stiffness was measured with two parameters: pulse wave velocity (PWV) and the augmentation index (AI). Intima-media thickness (IMT) was used as indicator of atherosclerotic burden. Patient history, vascular parameters and blood- and urine analyses were obtained as well. Results Mean age was 69±9 years. PWV (n=22), AI (n=24) and SAF (n=29) were not significantly different between patients with PAD, AAA and concomitant disease. A multivariate model found a positive relationship of AI with SAF, in a model with SAF, age, sex and presence of PAD and AAA, approaching significance (r2=0.53, p=0.070). The same model showed no relationship of PWV with SAF (r2=0.28, p=0.547). Univariate analysis showed no association between SAF and mean IMT (r=0.285, p=0.168) or maximum IMT and SAF (r=0.236, p=0.257). SAF was positively correlated with glucose and pack years. PWV was positively correlated with pulse pressure; AI had a negative correlation with height and was increased in women. Discussion SAF is positively related with vascular stiffness measured with AI, but not PWV. These contrasting results could not be fully explained but do suggest that AGEs play a role in the mechanical wall properties of patients with PAD and AAA. Further research should be performed in a larger population after ARTERY inclusion has been completed.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Lefrandt, Dr. J.D. and internal medicine-vascular medicine and Department and institute: and University Medical Center Groningen, department of vascular |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:57 |
| Last Modified: | 25 Jun 2020 10:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1719 |
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