Increased accumulation of skin advanced glycation end-products precedes and correlates with clinical manifestation of diabetic neuropathy

Abstract

Skin autofluorescence correlates with the severity of peripheral and autonomic nerve abnormalities in diabetes, even before being clinically manifest. The AFR may be a convenient and rapid clinical tool for assessing risk of progression of long-term diabetic complications.

Elevated skin autofluorescence is strongly associated with foot ulcers in patients with diabetes: a cross-sectional, observational study of Chinese subjects

“…Recently, Holman et al (2008) on behalf of the United Kingdom Prospective Diabetes Study (UKPDS) group, proposed that AGE probably is a carrier of the so-called metabolic memory or legacy. Our finding agreed with the result of Meerwaldt et al (2005a) that tissue AGE accumulation may represent the long-term effects of a final common pathway for various risk factors. Thus, based on the present work, skin AF might integrate these factors and is more informative than the actual levels of these risk factors themselves.…”

“…Meerwaldt et al (2005a) showed that skin AF was increased and correlated with the Wagner score in diabetics with neuropathy. Skin AF correlated inversely with nerve conduction velocity and amplitude.…”

“…Through these pathways, AGEs induce both cell dysfunction and extracellular matrix degeneration (Mišur et al, 2004;Meerwaldt et al, 2008;Peppa et al, 2009). Higher skin AF is also associated with diabetic nephropathy, neuropathy, and cardiovascular disease in cross-sectional studies (Meerwaldt et al, 2005a;Chabroux et al, 2010). However, little clinical evidence is available focusing on the evaluation of the role of skin AF in determining foot ulceration risk in diabetes.…”

Correlation of low molecular weight advanced glycation end products and nitric oxide metabolites with chronic complications in type 1 diabetic patients

“…However, to date there is only one report focused on the relationship of AGEs with diabetic neuropathy [5]. Therefore, the present study addresses two important questions: (i) whether accumulation of LMW-AGEs contributes to the pathogenesis of microvascular complications in type 1 diabetic patients, and (ii) if there is a correlation between LMW-AGEs and circulating NO metabolites (a surrogate indicator for circulating NO as marker of endothelial function).…”

“…LMW-AGEs react with susceptible proteins from the walls of blood vessels and contribute to the development of diabetic chronic complications [3]. Recent studies have found that an increase in accumulation of fluorescent Correlation of low molecular weight advanced glycation end products and nitric oxide metabolites with chronic complications in type 1 diabetic patients products (in skin) even before the clinic manifestation of diabetic neuropathy present [5]. Several reports have indicated that LMW-AGEs correlate with progressive renal injury in human type 1 and type 2 diabetes [6,7], but not with diabetes per se [8].…”