Clinical significance of skin autofluorescence for diabetic macroangiopathy and comparison with conventional markers of atherosclerosis: a cross-sectional and prospective study

Aoki, Ema; Hirashima, Takeo; Kumamoto, Yuko; Yamamoto, Yuko; Suzuki, Naoki; Oshima, Taito; Saito, Daizo; Hirano, Tsutomu

doi:10.1007/s13340-022-00608-8

Cited by 3 publications

(15 citation statements)

References 46 publications

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“…This suggests SAF's extended utility in CV risk management for this specific group. Additionally, in contrast to the results of Aoki et al [39], Conway et al [47] demonstrated a strong connection between SAF and coronary artery calcification (CAC) occurrence and progression in type 1 DM (T1DM) patients. Patients included in this study had a long-standing DM duration, of more than 30 years, thus further broadening SAF's applicability in CV risk evaluation of different populations exposed to hyperglycemia.…”

Section: Saf As a Marker For CV Risk Assessment In T2dm Patientsmentioning

confidence: 83%

“…The span of four years and one month, as observed across the analyzed studies, represents a significant duration in observing the progression of CV complications in T2DM patients, and in assessing the prognostic utility of SAF in this population. It emphasizes the role of longitudinal research in establishing links and potential causal relationships within the field of DM and CV investigations [38][39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

“…Investigating skin AGEs as measured by SAF in the context of macroangiopathy, Aoki et al [39] aimed to determine whether SAF could surpass IMT and PWV as conventional markers of atherosclerosis. SAF, IMT, and PWV were influenced by age, DM duration, and estimated glomerular filtration rate (eGFR), as well as significantly interrelated.…”

Section: Saf As a Marker For CV Risk Assessment In T2dm Patientsmentioning

confidence: 99%

“…Other studies may have specific population characteristics [40], or relatively small groups included in the analysis [41], influencing the extrapolation to other or broader populations. Variations in measurement methods, timing, and calibrations needed by the device could also introduce variability in the results [39,43].…”

Section: Atherosclerotic Cvdmentioning

confidence: 99%

“…In these studies, the impact of skin pigmentation was not mentioned as being consistently addressed, an important bias when ethnically diverse populations are included [39,41,42]. Some other possible sources of bias may include the research settings (such as hospitalbased [38] versus community-based [39]), as well as the inclusion criteria, which could potentially introduce selection biases. Confounding factors such as unmeasured or inadequately measured variables (dietary patterns, socioeconomic conditions) could potentially influence the observed associations.…”

Section: Atherosclerotic Cvdmentioning

confidence: 99%

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Skin Autofluorescence as a Potential Adjunctive Marker for Cardiovascular Risk Assessment in Type 2 Diabetes: A Systematic Review

Reurean-Pintilei,

Pantea Stoian,

Potcovaru

et al. 2024

IJMS

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Diabetes mellitus (DM), due to its long-term hyperglycemia, leads to the accumulation of advanced glycation end-products (AGEs), especially in the vessel walls. Skin autofluorescence (SAF) is a non-invasive tool that measures AGEs. DM patients have a rich dietary source in AGEs, associated with high oxidative stress and long-term inflammation. AGEs represent a cardiovascular (CV) risk factor, and they are linked with CV events. Our objective was to assess whether SAF predicts future CV events (CVE) by examining its association with other CV risk factors in patients with type 2 DM (T2DM). Additionally, we assessed the strengths and limitations of SAF as a predictive tool for CVE. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, we conducted a systematic review with CRD42024507397 protocol, focused on AGEs, T2DM, SAF, and CV risk. We identified seven studies from 2014 to 2024 that predominantly used the AGE Reader Diagnostic Optic tool. The collective number of patients involved is 8934, with an average age of 63. So, SAF is a valuable, non-invasive marker for evaluating CV risk in T2DM patients. It stands out as a CV risk factor associated independently with CVE. SAF levels are influenced by prolonged hyperglycemia, lifestyle, aging, and other chronic diseases such as depression, and it can be used as a predictive tool for CVE.

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Section: Saf As a Marker For CV Risk Assessment In T2dm Patientsmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Saf As a Marker For CV Risk Assessment In T2dm Patientsmentioning

confidence: 99%

Section: Atherosclerotic Cvdmentioning

confidence: 99%

Section: Atherosclerotic Cvdmentioning

confidence: 99%

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Skin Autofluorescence as a Potential Adjunctive Marker for Cardiovascular Risk Assessment in Type 2 Diabetes: A Systematic Review

Reurean-Pintilei,

Pantea Stoian,

Potcovaru

et al. 2024

IJMS

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Cellular Patterns of the Skin Microenvironment in Experimentally Induced Diabetes Mellitus

Temelie-Olinici,

Botezatu,

Perțea

et al. 2024

Preprint

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Diabetes mellitus is one of the most common endocrinopathies, estimated to affect about 5.4% of the world's population around 2025. It is thought that nearly a third of diabetic patients have some type of skin condition. Frequently, the cutaneous effects of this heterogeneous syndrome are ac-curately detected late in the progressive form of the disease. The main objective of the present study was to identify the main cellular characteristics of the cutaneous microenvironment in exper- imentally induced diabetes mellitus. Skin fragments were harvested from adult white Wistar rats of both sexes, with the weight of 200 g, 12 weeks after streptozotocin diabetes was induced. In parallel with histopathological diagnosis by using hematoxylin and eosine staining, samples were processed by transmission electron microscopy technique and examined with a Philips CM100 microscope. In the apparently macroscopically unchanged tegument, photon microscopy revealed both progres ive thinning of the epidermis in the early stages of diabetes and a significant process of fibrosis and collagen hyalinization in the dermis. In addition, in the early stages, the electron microscopic study provided ultrastructural details characteristic of a senescent phenotype with reduced cell proliferation. The morphological changes in the skin may be the first signs of disruption of carbohydrate metabolism and in the case of established diabetes may reflect its progression and the efficacy of therapy.

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Associations between Skin Autofluorescence Levels with Cardiovascular Risk and Diabetes Complications in Patients with Type 2 Diabetes

Reurean-Pintilei,

Pantea Stoian,

Salmen

et al. 2024

Biomedicines

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Advanced Glycation End Products (AGEs) contribute to the pathophysiology of type 2 diabetes mellitus (T2DM) and cardiovascular (CV) diseases (CVDs), making their non-invasive assessment through skin autofluorescence (SAF) increasingly important. This study aims to investigate the relationship between SAF levels, cardiovascular risk, and diabetic complications in T2DM patients. We conducted a single-center, cross-sectional study at Consultmed Hospital in Iasi, Romania, including 885 T2DM patients. The assessment of SAF levels was performed with the AGE Reader™, (Diagnoptics, Groningen, The Netherlands). CVD prevalence was 13.9%, and according to CV risk category distribution, 6.1% fell into the moderate-risk, 1.13% into the high-risk, and 92.77% into the very-high-risk category. The duration of DM averaged 9.0 ± 4.4 years and the mean HbA1c was 7.1% ± 1.3. After adjusting for age and eGFR, HbA1c values showed a correlation with SAF levels in the multivariate regression model, where a 1 SD increase in HbA1c was associated with a 0.105 SD increase in SAF levels (Nagelkerke R2 = 0.110; p < 0.001). For predicting very high risk with an SAF cut-off of 2.35, sensitivity was 67.7% and specificity was 56.2%, with an AUC of 0.634 (95% CI 0.560–0.709, p = 0.001). In T2DM, elevated SAF levels were associated with higher CV risk and HbA1c values, with 2.35 identified as the optimal SAF cut-off for very high CV risk.

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Clinical significance of skin autofluorescence for diabetic macroangiopathy and comparison with conventional markers of atherosclerosis: a cross-sectional and prospective study

Cited by 3 publications

References 46 publications

Skin Autofluorescence as a Potential Adjunctive Marker for Cardiovascular Risk Assessment in Type 2 Diabetes: A Systematic Review

Skin Autofluorescence as a Potential Adjunctive Marker for Cardiovascular Risk Assessment in Type 2 Diabetes: A Systematic Review

Cellular Patterns of the Skin Microenvironment in Experimentally Induced Diabetes Mellitus

Associations between Skin Autofluorescence Levels with Cardiovascular Risk and Diabetes Complications in Patients with Type 2 Diabetes

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