Higher skin autofluorescence in young people with Type 1 diabetes and microvascular complications

Cho, Yoon Hi; Craig, Maria E.; Januszewski, Andrzej S.; Benitez‐Aguirre, Paul; Hing, Stephen; Jenkins, Alicia J.; Donaghue, Kim C.

doi:10.1111/dme.13280

Cited by 17 publications

(24 citation statements)

References 32 publications

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“…The skin concentrations of AGEs have been related to coronary calcifications, left ventricular masses and progression of intima-media thickness in the DCCT-EDIC study [ 11 ]. SAF was related to the age of the participants (ß = + 0.397; p < 0.001) which is very similar to reports from other groups in participants with T1D [ 26 – 28 ]. Although an indirect estimation of the accumulation of AGEs, SAF has some advantages on skin biopsies: low cost, simplicity, non-invasiveness, and repeatability.…”

Section: Discussionsupporting

confidence: 83%

Skin autofluorescence predicts major adverse cardiovascular events in patients with type 1 diabetes: a 7-year follow-up study

Blanc-Bisson

Vélayoudom-Céphise

Cougnard‐Grégoire

et al. 2018

Cardiovasc Diabetol

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BackgroundAdvanced glycation end-products play a role in diabetic vascular complications. Their optical properties allow to estimate their accumulation in tissues by measuring the skin autofluorescence (SAF). We searched for an association between SAF and major adverse cardiovascular events (MACE) incidence in subjects with Type 1 Diabetes (T1D) during a 7 year follow-up.MethodsDuring year 2009, 232 subjects with T1D were included. SAF measurement, clinical [age, sex, body mass index (BMI), comorbidities] and biological data (HbA1C, blood lipids, renal parameters) were recorded. MACE (myocardial infarction, stroke, lower extremity amputation or a revascularization procedure) were registered at visits in the center or by phone call to general practitioners until 2016.ResultsThe participants were mainly men (59.5%), 51.5 ± 16.7 years old, with BMI 25.0 ± 4.1 kg/m2, diabetes duration 21.5 ± 13.6 years, HbA1C 7.6 ± 1.1%. LDL cholesterol was 1.04 ± 0.29 g/L, estimated Glomerular Filtration Rates (CKD-EPI): 86.3 ± 26.6 ml/min/1.73 m2. Among these subjects, 25.1% were smokers, 45.3% had arterial hypertension, 15.9% had elevated AER (≥ 30 mg/24 h), and 9.9% subjects had a history of previous MACE. From 2009 to 2016, 22 patients had at least one new MACE: 6 myocardial infarctions, 1 lower limb amputation, 15 revascularization procedures. Their SAF was 2.63 ± 0.73 arbitrary units (AU) vs 2.08 ± 0.54 for other patients (p = 0.002). Using Cox-model, after adjustment for age (as the scale time), sex, diabetes duration, BMI, hypertension, smoking status, albumin excretion rates, statin treatment and a previous history of MACE, higher baseline levels of SAF were significantly associated with an increased risk of MACE during follow-up (HR = 4.13 [1.30–13.07]; p = 0.02 for 1 AU of SAF) and Kaplan–Meier curve follow-up showed significantly more frequent MACE in group with SAF upper the median (p = 0.001).ConclusionA high SAF predicts MACE in patients with T1D.Electronic supplementary materialThe online version of this article (10.1186/s12933-018-0718-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 83%

Skin autofluorescence predicts major adverse cardiovascular events in patients with type 1 diabetes: a 7-year follow-up study

Blanc-Bisson

Vélayoudom-Céphise

Cougnard‐Grégoire

et al. 2018

Cardiovasc Diabetol

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“…A recent cross-sectional study conducted on adolescents with T1D showed that higher SAF was associated with retinopathy, defined as the presence of at least one microaneurysm or haemorrhage using seven-field stereoscopic fundal photography, and cardiac autonomic dysfunction defined as abnormal standard deviation of mean normal-to-normal (NN) intervals for age and gender. Authors found no association between SAF and the other complication outcomes (peripheral nerve dysfunction, pupillometry abnormalities or elevated albumin excretion rate) (116). According to these findings, SAF could be considered a useful non-invasive screening tool to predict microvascular complications also in paediatric patients with T1D.…”

Section: Skin Advanced Glycation End-productsmentioning

confidence: 95%

“…Although AGEs may be considered an alternative tool to provide information on cumulative hyperglycaemic states, van der Heyden et al reported that some patients had an elevated SAF despite a HbA1c value within target, suggesting that genetic factors could influence the level of glycation of HbA1c or the production of AGEs (114). Conversely, other researchers found SAF/SIF to be associated with mean HbA1c over the preceding year (115)(116)(117). Indeed, skin AGEs reflect the memory of glycometabolic stress, thus skin AGE levels are more correlated with long-term HbA1c rather than concurrent HbA1c.…”

Section: Skin Advanced Glycation End-productsmentioning

confidence: 99%

“…Indeed, skin AGEs reflect the memory of glycometabolic stress, thus skin AGE levels are more correlated with long-term HbA1c rather than concurrent HbA1c. SAF appears to increase faster in older adolescents (114,116). A recent cross-sectional study conducted on adolescents with T1D showed that higher SAF was associated with retinopathy, defined as the presence of at least one microaneurysm or haemorrhage using seven-field stereoscopic fundal photography, and cardiac autonomic dysfunction defined as abnormal standard deviation of mean normal-to-normal (NN) intervals for age and gender.…”

Section: Skin Advanced Glycation End-productsmentioning

confidence: 99%

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Skin Involvement in Paediatric Patients with Type 1 Diabetes

Passanisi¹,

Salzano²,

Lombardo³

2021

Preprint

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Skin involvement is an overlooked aspect in the management of paediatric patients with type 1 diabetes. A comprehensive search of published literature using the PubMed database was carried out using the following key terms: “children”, “pediatric/paediatric patients”, “skin”, “skin disorders”, “type 1 diabetes”. Dermatological side effects are frequently observed among diabetic children and adolescents. Insulin-induced lipodystrophies and allergic contact dermatitis caused by insulin pumps or glycaemic sensors are the most common skin reactions in these patients. Furthermore, several diabetes-associated skin diseases such as necrobiosis lipoidica, granuloma annulare, vitiligo, and bullosis diabeticorum may already be present in paediatric age. Paediatric diabetes specialists should pay attention to their patients’ skin so as to recognize these disorders, identify the potential causes, and choose the most suitable treatment. Finally, the evaluation of skin concentrations of advanced glycation end-products using non-invasive diagnostic techniques may be used to assess the risk of chronic complications of diabetes as early as adolescence.

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“…6,13,14 Physiologically microvasculatures are primarily regulated by autonomic nervous system with a balance between sympathetic and para-sympathetic neurons. [15][16][17][18][19][20][21] While it is feasible to biochemically measure the neurotransmitters of sympathetic and para-sympathetic neurons, often the sensitivity of detecting the neurotransmitters is feasible only when they are significantly elevated. Hence detection of borderline changes in the concentrations of the neurotransmitters remains a technical challenge.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of the Merit of Iris-pupil Area Ratio as a Predictor of Risk of Myocardial Infarction

Chinaka

Kumar

2020

BEMS Reports

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Background: We have recently reported the utility of iris-pupil area ratio as a sensitive index of borderline changes in sympathetic activity and the stress associated with it in primates and canines. As minimal increase in sympathetic activity can lead to micro vascular constriction, which is often observed in patients suffering from myocardial infarction, we hypothesised here that iris-pupil area ratio will serve as a predictor of risk of myocardial infarction in humans. Materials and Methods: To test our hypothesis, we analysed and compared the digital images of the eyes of celebrities who succumbed to myocardial infarction with that of healthy celebrities. Most recent digital images of the celebrities available in the public database were used for our analysis. Iris-pupil area ratio of both eyes was measured using NIH Image-J software. Results: The iris-pupil area ratio was significantly lower in celebrities who succumbed to myocardial infarction compared to healthy cohorts (4.875 ± 1.506 Vs. 6.978 ± 1.499; p<0.001). To assess the correlation of age with iris-pupil area ratio we performed regression analysis of the data from each of the cohorts. The age Vs iris-pupil area ratio regression analysis in celebrities who succumbed to myocardial infarction had positive correlation (correlation coefficient of 0.06889), while healthy celebrities showed negative correlation (correlation coefficient of 0.03775). Although the correlation between age and iris-pupil area ratio was weak, a higher negative correlation (correlation coefficient of 0.387) was observed in a cohort of 50 to 80 years old healthy celebrities. Conclusion: The lower iris-pupil area ratio observed in celebrities who succumb to myocardial infarction possibly suggests increased sympathetic activity and microvascular constriction, which supports the merit of iris-pupil area ratio as a non-invasive tool in predicting myocardial infarction.

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Higher skin autofluorescence in young people with Type 1 diabetes and microvascular complications

Cited by 17 publications

References 32 publications

Skin autofluorescence predicts major adverse cardiovascular events in patients with type 1 diabetes: a 7-year follow-up study

Skin autofluorescence predicts major adverse cardiovascular events in patients with type 1 diabetes: a 7-year follow-up study

Skin Involvement in Paediatric Patients with Type 1 Diabetes

A Retrospective Analysis of the Merit of Iris-pupil Area Ratio as a Predictor of Risk of Myocardial Infarction

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