Blood vessel stiffness and level of glycation end products in the skin of patients with chronic kidney disease

Uvod: Cilj istraživanja bio je ispitati razinu oksidativnog stresa korištenjem „AGE Reader“ uređaja i krutost krvnih žila korištenjem „Agedio B900“, te njihovu međusobnu povezanost u populaciji bolesnika s KBB. Sekundarni cilj bio je istražiti korelacije između AGE, PWv, CSAT, CDAT i svih mjernih parametara za skupinu bolesnika s KBB. Materijali i metode: Istaživanje je provedeno na 96 bolesnika s KBB, od kojih je 57 (59%) muškaraca i 39 (41%) žena. Medijan dobi svih bolesnika je 64 godine (interkvartilnog raspona od 51 do 72 godine) u rasponu od 20 do 84 godina. Glavni ispitivani parametri za svakog ispitanika s KBB bili su: opseg struka (cm), opseg bokova (cm), opseg nadlaktice (cm), dob i spol ispitanika, tjelesna tjelesna masa (kg) i tjelesna visina (cm). Vrijednosti arterijskih tlakova izmjerene su pomoću „Agedio B900“ uređaja koji mjeri centralni i periferni arterijski tlak, hemodinamske parametre te procjenjuje krutost krvnih žila. Analiza sastava tijela dobivena je pomoću uređaja „Tanita MC780 Multi Frequency segmentnog analizatora sastava“. Vrijednost krajnjih produkata glikacije (AGEs) u koži bolesnika mjerena uz pomoć „AGE Reader“ uređaja. Rezultati: U ovom istraživanju 69 pacijenata s KBB (73%) boluje od AH. Analizirajući razlike između muškaraca i žena nije opažena statistički značajna razlika u učestalosti, dobi prilikom dijagnoze i duljini liječenja AH u populaciji bolesnika s KBB. Među promatrani laboratorijskim parametrima, nađeno je kako je kod žena vrijednost HDL-a statistički značajno veća nego kod muškaraca (P<0,001). Rezultati dobiveni koristeći uređaje „Agedio B900“ i „AGE Reader“ ukazuju da je augmentacijski indeks (P=0,002) statistički značajno veći kod žena. AGE vrijednosti nisu statistički značajno različite između spolova. Zamjećena je pozitivna statistički značajana povezanost između PWv-a i AGE vrijednosti (r=0,522, P<0,001), dok statistički značajna povezanost između CSAT, PSAT i AGE vrijednosti nije pronađena. Značajna pozitivna povezanost s PWv-om uočena je kod količine visceralnog masnog tkiva (r=0,336, P<0,001) i metaboličke dobi (r=0,703, P<0,001). Također, rezultati ovog istraživanja upućuju na negtivnu statistički značajnu povezanost između PWv vrijednosti i skeletne mišićne mase (r=-0,31, P= 0,01) te faznog kuta (r=-0,395, P <0,001). Rezultati pokazuju kako je statistički značajna negativna povezanost AGE vrijednosti s nemasnaom tjelesnom masaom (r=-0,235, P=0,030), mišićnom masom (r=-0,236, P=0,003) i skeletnom mišićnom masom (r=-0,272, P=0,010). Statistički značajna pozitivna povezanost s AGE-a dobivena je kod metaboličke dobi (r=0,343, P<0,001). Uočena je pozitivna statistički značajna povezanost između CSAT i visceralnog masnog tkiva (r=0,278, P=0,020). Zaključak: Postoji povezanost između PWv vrijednosti, markera krutosti krvnih žila i razine oksidativnog stresa mjerene kroz vrijednost AGE-a kod bolesnika s KBB.Introduction: The aim of the research was to examine the level of oxidative stress using the "AGE Reader" device and the stiffness of blood vessels using the "Agedio B900", and their correlation in the population of patients with CKD. The secondary objective was to investigate correlations between AGE, PWv, CSAT, CDAT and all measurement parameters for the group of patients with CKD. Materials and methods: The study was conducted on 96 patients with CKD, of which 57 (59%) were men and 39 (41%) were women. The median age of all patients is 64 years (interquartile range from 51 to 72 years), in the range from 20 to 84 years. The main investigated parameters for each subject with CKD were: waist circumference (cm), hip circumference (cm), upper arm circumference (cm), subject's age and sex, body mass (kg) and body height (cm). Arterial pressure values were measured using the "Agedio B900" device, which measures central and peripheral arterial pressure, hemodynamic parameters, and assesses the stiffness of blood vessels. Body composition analysis was obtained using the "Tanita MC780 Multi Frequency segmental composition analyzer" device. The value of glycation end products (AGEs) in the patient's skin measured with the help of the "AGE Reader" device. Results: In this study, 69 patients with CKD (73%) suffered from AH. Analyzing the differences between men and women, no statistically significant difference was observed in the frequency, age at diagnosis and length of treatment of AH in the population of patients with CKD. Among the observed laboratory parameters, it was found that the value of HDL was statistically significantly higher in women than in men (P<0.001). The results obtained using the devices "Agedio B900" and "AGE Reader" indicate that the augmentation index (P=0.002) is statistically significantly higher in women. AGE values are not statistically significantly different between the sexes. A positive statistically significant correlation was observed between PWv and AGE values (r=0.522, P<0.001), while no statistically significant correlation was found between CSAT, PSAT and AGE values. A significant positive association with PWv was obtained for the amount of visceral fat tissue (r=0.336, P<0.001) and metabolic age (r=0.703, P<0.001). Also, the results of this research indicate a negative statistically significant relationship between PWv value and skeletal muscle mass (r=-0.31, P= 0.010) and phase angle (r=-0.395, P <0.001). The results show that there is a statistically significant negative association of AGE values with lean body mass (r=-0.235, P=0.030), muscle mass (r=-0.236, P=0.003) and skeletal muscle mass (r=-0.272, P =0.010). A statistically significant positive association with AGE was obtained with metabolic age (r=0.343, P