Advanced Glycation End Products Assessed by Skin Autofluorescence: A New Marker of Diabetic Foot Ulceration

Vouillarmet, Julien; Maucort-Boulch, Delphine; Michon, P; Thivolet, Charles

doi:10.1089/dia.2013.0009

Cited by 33 publications

(49 citation statements)

References 33 publications

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“…Despite this moderately high VPT value, the highest sAF quartile was independently associated with increased VPT. High sAF has already been reported in patients with foot ulcers, the main morbidity of DPN [27,28]. Our results show that even before reaching a VPT that reflects a severe lesion of a large nerve fibre or a high risk of foot ulcer, sAF reflects the worsening of large fibre function.…”

Section: Discussionsupporting

confidence: 67%

Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes

Rajaobelina

Farges

Nov

et al. 2016

Diabetes Metabolism Res

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Objective Advanced glycation end products (AGEs) are involved in diabetes complications. We aimed to investigate whether the accumulation of AGEs measured by skin autofluorescence (sAF) was associated with signs of diabetic peripheral neuropathy and to sensitivity, pain, motor and autonomic function 4 years later in patients with type 1 diabetes.Methods At baseline, 188 patients (age 51 years, diabetes duration 22 years) underwent skin autofluorescence measurement using the AGE Reader. Four years later, signs of diabetic peripheral neuropathy were defined as the presence of neuropathic pain and/or feet sensory loss or foot ulceration. Neurological tests were systematically performed: vibration perception threshold by neuroesthesiometry, neuropathic pain by the Douleur Neuropathique en 4 Questions score, muscle strength by dynamometry and electrochemical skin conductance. Multivariate analyses were adjusted by age, sex, height, body mass index, tobacco, HbA 1c , diabetes duration, estimated glomerular filtration rate and albumin excretion rate.Results At the 4-year follow-up, 13.8% of patients had signs of diabetic peripheral neuropathy. The baseline sAF was higher in those with signs of diabetic peripheral neuropathy (2.5 ± 0.7 vs 2.1 ± 0.5 arbitrary units (AU), p < 0.0005). In the multivariate analysis, a 1 SD higher skin autofluorescence at baseline was associated with an increased risk of signs of neuropathy (OR = 2.68, p = 0.01). All of the neurological tests were significantly altered in the highest quartile of the baseline sAF (>2.4 AU) compared with the lowest quartiles after multivariate adjustment.Conclusion This non-invasive measurement of skin autofluorescence may have a value for diabetic peripheral neuropathy in type 1 diabetes and a potential clinical utility for detection of diabetic peripheral neuropathy.

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Section: Discussionsupporting

confidence: 67%

Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes

Rajaobelina

Farges

Nov

et al. 2016

Diabetes Metabolism Res

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“…Accumulating evidence obtained with the AGE reader has raised unexpected issues regarding the pathological roles of tissue AGE aggregation in various disorders, such as rheumatoid arthritis 36) , foot ulceration 37) , schizophrenia 38) , and cognitive dysfunction 39) . Because the reasons for tissue AGE accumulation being related to these conditions are unclear, further research aimed at both elucidating the underlying mechanism and developing strategies for reducing AGE accumulation is required.…”

Section: Discussionmentioning

confidence: 99%

Association of Advanced Glycation End Products with coronary Artery Calcification in Japanese Subjects with Type 2 Diabetes as Assessed by Skin Autofluorescence

Hangai

Takebe

Honma

et al. 2016

J Atheroscler Thromb

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Aim: Advanced glycation end products (AGE) are considered to be among the critical pathogenic factors involved in the progression of diabetic complications. Skin autofluorescence (AF), a noninvasive measurement of AGE accumulation, has been recognized as a useful and convenient marker for diabetic vascular diseases in Caucasians. This study aimed to evaluate the association of tissue AGE, assessed using skin AF, with coronary artery calcification in Japanese subjects with type 2 diabetes.Methods: In total, 122 Japanese subjects with type 2 diabetes enrolled in this cross-sectional study underwent multi-slice computed tomography for total coronary artery calcium scores (CACS) estimation and examination with a skin AF reader.Results: Skin AF positively correlated with age, sex, diabetes duration, pulse wave velocity, systolic blood pressure, serum creatinine, and CACS. In addition, skin AF results negatively correlated with BMI, eGFR, and serum C-peptide concentration. According to multivariate analysis, age and systolic blood pressure showed strong positive correlation and eGFR showed negative correlation with skin AF values. Multiple linear regression analyses revealed a significant positive correlation between skin AF values and logCACS, independent of age, sex, diabetes duration, HbA1c, BMI, IMT, and blood pressure. However, skin AF showed no association with serum levels of AGE, such as Nε-(carboxymethyl) lysine and 3-deoxyglucosone.Conclusion: Skin AF results positively correlated with CACS in Japanese subjects with type 2 diabetes. This result indicates that AGE plays a role in the pathogenesis of diabetic macrovascular disease. Measurement of skin AF values may be useful for assessing the severity of diabetic complications in Japanese subjects.

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“…AGE concentration is strongly associated with the presence of PAD in diabetic patients and shows an inverse correlation with ABI [81]. Furthermore, AGE levels are higher in patients with, rather than without, DFU at the same level of micro-and macroangiopathy [82]. One specific impact of glycation observed on the healing process was due to an alteration in angiogenesis and impaired keratinocyte migration [83,84].…”

Section: The Link Between Healing and Pad: Room For Other Actorsmentioning

confidence: 99%

Lower-extremity arterial revascularization: Is there any evidence for diabetic foot ulcer-healing?

Vouillarmet

Bourron

Gaudric³

et al. 2016

Diabetes & Metabolism

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Advanced Glycation End Products Assessed by Skin Autofluorescence: A New Marker of Diabetic Foot Ulceration

Abstract: Increased SAF levels are associated with neuropathic foot complications in diabetes. Use of SAF measurement to assess foot vulnerability and to predict DFU events in high-risk patients appears to be promising.

Cited by 33 publications

References 33 publications

Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes

Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes

Association of Advanced Glycation End Products with coronary Artery Calcification in Japanese Subjects with Type 2 Diabetes as Assessed by Skin Autofluorescence

Lower-extremity arterial revascularization: Is there any evidence for diabetic foot ulcer-healing?

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