Are Advanced Glycation End Products in Skin Associated with Vascular Dysfunction Markers? A Meta-Analysis

Abstract

Evidence exists regarding the association between advanced glycation end products and different cardiovascular disease subclinical processes, such as arterial stiffness and atherosclerosis. With this systematic review and meta-analysis, we aimed to provide a synthesis of the evidence regarding the association of arterial stiffness measured by pulse wave velocity and atherosclerosis measured by carotid intima media thickness with skin autofluorescence. A systematic search was performed using: MEDLINE (PubMed), SCOPUS, and Web of Science, until 30 March 2020. Cross-sectional studies or baseline data from prospective longitudinal studies were considered. The DerSimonian and Laird method was used to calculate the pooled estimates of correlation coefficients and the corresponding 95% confidence intervals (CI) for the association of pulse wave velocity and carotid intima media thickness with skin autofluorescence. Twenty-five studies were included in the systematic review and meta-analysis, including 6306 subjects. The pooled correlation coefficient was 0.25 (95% CI: 0.18, 0.31) for pulse wave velocity and skin autofluorescence, and 0.31 (95% CI: 0.25, 0.38) for carotid intima media thickness and skin autofluorescence. This systematic review and meta-analysis provide a synthesis of the evidence showing a positive weak association of pulse wave velocity and carotid intima media thickness with skin autofluorescence.

Clinical significance of non-invasive skin autofluorescence measurement in patients with diabetes: a systematic review and meta-analysis

“…Moreover, several skin proteins fluorescence within wavelengths overlap with AGEs spectra, thus SAF measurement is not specific [44]. However, investigators have established that AGE reader measures tissue AGE that is highly positively correlated with fluorescent and nonfluorescent tissue AGE measures in skin biopsies [51].…”

Advanced Glycations End Products in the Skin as Biomarkers of Cardiovascular Risk in Type 2 Diabetes

“…Lutgers et al demonstrated that SAF provides additional information to the UKPDS risk score for the estimation of cardiovascular prognosis in T2D [ 71 ]. In addition, there is emerging evidence indicating that SAF is an important biomarker not only of the presence of cardiovascular disease but also of their outcomes [ 72 , 73 ].…”

“…AGE accumulation leads to quantitative and qualitative alterations of collagens and elastin, which could contribute to the decreased elastic properties of the vessels, thereby playing a role in arterial stiffness [ 87 ]. SAF is strongly correlated with pulse wave velocity, brachial and aortic augmentation indices, and ankle-brachial index, all of them markers of arterial stiffness [ 72 ]. Birukov et al [ 84 ] recently investigated the relationships between SAF and vascular stiffness in a large study performed in diabetic and non-diabetic populations.…”

New Insights in Prevention and Treatment of Cardiovascular Disease

“…A systematic review and meta-analysis by Saz-Lara, A. et al [ 53 ], aimed to provide a synthesis of the evidence regarding the association of arterial stiffness measured by pulse wave velocity and atherosclerosis measured by carotid intima media thickness with advanced glycation end products assessed by skin autofluorescence. An innovative approach to indirectly estimate vascular subclinical damage.…”