Increased skin autofluorescence of advanced glycation end-products (AGEs) in Tunisian hemodialysis patients with heart failure
Authors:   Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Tunisia., Sakly Rim , Lecube Albert ,   Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova. Obesity, Diabetes and Metabolism (ODIM) Research Group, IRBLleida. University of Lleida, Lleida, Spain., Aloui Sabra ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Ajimi Khawla ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Hamouda Mouna ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Letaief Ahmed ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Hawala Fouazi ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Salem Mariem Ben ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Mahmoud Nouha Ben ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Salah Manel Ben ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Skhiri Habib ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Wolffenbuttel Bruce H R ,   Department of Nephrology, Fattouma Bourguiba University Hospital of Monastir, Tunisia., Abid Salwa ,   Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands., Kerkeni Mohsen ,   Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Tunisia.
Published: September 2022

Background: Cardiovascular disease (CVD) is the main reason for morbidity and mortality of patients in hemodialyis. Skin autofluorescence (SAF), a noninvasive measurement method, reflects tissue accumulation of advanced glycation end products (AGEs) that has been implicated in CVD as a strong marker. The aim of this study was to evaluate SAF profile in hemodialysis patients and to assess the association between SAF and heart failure. Methods: In a cross-sectional study, we included 60 hemodialysis (HD) patients who were subdivided in two groups: a HD group without heart failure (n=39) and a HD group with heart failure (n=21). Skin AGEs accumulation was measured by AGE Reader device and clinical data was obtained. Results: HD patients showed a SAF value at 2.90 (2.40-3.60). HD patients with diabetes mellitus have an increased SAF levels compared to HD patients without diabetes [3.20 (2.90-3.95) vs. 2.70 (2.30-3.30) AU, P = 0.021; respectively]. Furthermore, HD patients with heart failure showed a significant increased SAF levels compared to HD patients without heart failure [3.65 (2.90-4.12) vs. 2.60 (2.30-3.20) AU, P <0.001; respectively]. SAF was associated with age, gender, and duration of dialysis. The ROC analysis indicated that SAF at 3.05 AU was optimal cut-off point for presence of heart failure (P <0.001). Conclusion: SAF might be a rapid and helpful tool in clinical practice as a potential marker for evaluating and screening heart failure in HD patients non-invasively and might be used as predictor for clinicians. Keywords: skin autofluorescence; advanced glycation end products; hemodialysis; heart failure.