Abstract:Advanced glycation end products (AGEs) accumulate during renal failure and dialysis. Kidney transplantation is thought to reverse this accumulation by restoring renal function. Using a noninvasive and validated autofluorescence reader, we evaluated AGE levels in 285 transplant recipients (mean age, 52 years; range, 41 to 60 years), 32 dialysis patients (mean age, 56 years; range, 43 to 65 years), and 231 normal control subjects (mean age, 51 years; range, 40 to 65 years). Measurements in transplant recipients … Show more
“…Additionally, skin autofluorescence was measured in a nondiabetic control group of 231 consecutive preoperativeevaluation visitors of the outpatient clinic who did not have a history of diabetes, cardiovascular events, or renal disease (15). The study was approved by the local ethical committee.…”
OBJECTIVE—Advanced glycation end products (AGEs) are thought to have a role in the pathogenesis of diabetes complications. We recently reported the association between skin autofluorescence, as a measure of tissue AGE accumulation, and diabetic neuropathy in a selected diabetic population. In this study, we investigated the relation between skin autofluorescence and clinical variables including micro- and macrovascular complications in a type 2 diabetes primary care population.
RESEARCH DESIGN AND METHODS—Clinical data and skin autofluorescence were obtained in the type 2 diabetes group (n = 973) and in a control group (n = 231). Skin autofluorescence was assessed by illumination of the lower arm with a fluorescent tube (peak intensity ∼370 nm).
RESULTS—Skin autofluorescence was significantly higher in type 2 diabetic patients compared with control subjects in each age category. Multiple regression analysis showed significant correlation of skin autofluorescence with age, sex, diabetes duration, BMI, smoking, HbA1c, plasma creatinine, HDL cholesterol, and albumin-to-creatinine ratio in the type 2 diabetes group (R2 = 25%) and with age and smoking in the control group (R2 = 46%). Skin autofluorescence was significantly higher in the type 2 diabetes group, with both micro- and macrovascular disease, compared with the group without complications and the group with only microvascular complications.
CONCLUSIONS—This study confirms in a large group of type 2 diabetic patients that skin autofluorescence is higher compared with age-matched control subjects and is associated with the severity of diabetes-related complications. Skin autofluorescence reflecting vascular damage might be a rapid and helpful tool in the diabetes outpatient clinic for identifying diabetic patients who are at risk for developing complications.
“…Additionally, skin autofluorescence was measured in a nondiabetic control group of 231 consecutive preoperativeevaluation visitors of the outpatient clinic who did not have a history of diabetes, cardiovascular events, or renal disease (15). The study was approved by the local ethical committee.…”
OBJECTIVE—Advanced glycation end products (AGEs) are thought to have a role in the pathogenesis of diabetes complications. We recently reported the association between skin autofluorescence, as a measure of tissue AGE accumulation, and diabetic neuropathy in a selected diabetic population. In this study, we investigated the relation between skin autofluorescence and clinical variables including micro- and macrovascular complications in a type 2 diabetes primary care population.
RESEARCH DESIGN AND METHODS—Clinical data and skin autofluorescence were obtained in the type 2 diabetes group (n = 973) and in a control group (n = 231). Skin autofluorescence was assessed by illumination of the lower arm with a fluorescent tube (peak intensity ∼370 nm).
RESULTS—Skin autofluorescence was significantly higher in type 2 diabetic patients compared with control subjects in each age category. Multiple regression analysis showed significant correlation of skin autofluorescence with age, sex, diabetes duration, BMI, smoking, HbA1c, plasma creatinine, HDL cholesterol, and albumin-to-creatinine ratio in the type 2 diabetes group (R2 = 25%) and with age and smoking in the control group (R2 = 46%). Skin autofluorescence was significantly higher in the type 2 diabetes group, with both micro- and macrovascular disease, compared with the group without complications and the group with only microvascular complications.
CONCLUSIONS—This study confirms in a large group of type 2 diabetic patients that skin autofluorescence is higher compared with age-matched control subjects and is associated with the severity of diabetes-related complications. Skin autofluorescence reflecting vascular damage might be a rapid and helpful tool in the diabetes outpatient clinic for identifying diabetic patients who are at risk for developing complications.
“…All study participants had tissue AGE measured using a previously validated cutaneous AF device using an ultraviolet source at a specific range of wavelengths (AGE Reader; DiagnOptics, Groningen, The Netherlands) (12,13). Values were compared with an age-matched non-CKD database contained within the device, generated from a Dutch cohort.…”
Background and objectives: Tissue-advanced glycation end products (AGE) are a measure of cumulative metabolic stress. Assessment of tissue AGE by skin autofluoresence (AF) correlates well with cardiovascular outcomes in hemodialysis (HD) patients. This study aimed to measure and compare tissue AGE levels in HD and peritoneal dialysis (PD) patients and to evaluate the impact of systemic PD glucose exposure.Design, setting, participants, & measurements: Tissue AGE were measured in 115 established dialysis patients (62 HD and 53 PD) using a cutaneous AF device (AGE Reader; DiagnOptics). Values were compared with an age-matched non-chronic kidney disease database. Review of all previous PD solution delivery/prescription data determined PD glucose exposure.Results: PD patients were similar in age to HD patients but had a shorter dialysis vintage. There were no differences in ischemic heart disease or smoking history, statin or angiotensin-converting enzyme inhibitor (ACEi) use, lipids, biochemistry, or prevalence of diabetes. More than 90% of both groups had met current dialysis adequacy targets. Skin AF values in PD and HD patients were similar and strongly correlated with historical PD glucose exposure. Skin AF correlated with age in both groups but with dialysis vintage only in PD patients Conclusions: Cumulative metabolic stress and transient hyperglycemia results in grossly elevated levels of tissue AGE in dialysis patients. In PD patients, this high level of AGE deposition is associated with historical glucose exposure. This observation provides a previously unappreciated potential link between PD exposure to glucose and systemic cardiovascular disease.
“…Various articles elucidate the link between natural fluorescence, glycation and diabetes [88][89][90][91][92] and in subsequent cardiovascular developments [93][94][95][96]. Biophoton emission may be linked to current DM indicators such as HbA1c [97,98]; and the detection of other medical conditions [89] including gastrointestinal disease(s) [99][100][101], cancers [102][103][104][105][106][107], conditions of unknown origin [108,109], and as an early marker of retinal deterioration [110,111].…”
Section: The Influence Of Pathology-related Bioluminescence Upon Colomentioning
Abstract:The absorption and emission of light by biological systems is a dilemma for the research community which remains transfixed upon the bottom-up systems biology approach. Many health care professionals do not yet accept that photosensitivity is an essential aspect of the body's function.This article highlights that light is often required to activate enzymes and/or proteins in biological systems. Inadequate levels of exposure to light may be responsible, at least in part, for the uncoiled nature of proteins found in diabetes mellitus, Alzheimer's disease, and other conditions. Moreover the emission of light, the consequence of protein reactions with reactive substrates or of reactive oxygen species, is an often observed characteristic of pathologies and influences the visual perception of colour. It illustrates that a significant diagnostic principle exists by measuring the levels of light absorbed and/or the bioluminescence released from fluorescent pathologies.
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