Is There a Link between Obesity Indices and Skin Autofluorescence? A Response from the ILERVAS Project

Abstract

There is controversial information about the accumulation of advanced glycation end-products (AGEs) in obesity. We assessed the impact of total and abdominal adiposity on AGE levels via a cross-sectional investigation with 4254 middle-aged subjects from the ILERVAS project. Skin autofluorescence (SAF), a non-invasive assessment of subcutaneous AGEs, was measured. Total adiposity indices (BMI and Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE)) and abdominal adiposity (waist circumference and body roundness index (BRI)) were assessed. Lean mass was estimated using the Hume index. The area under the receiver operating characteristic (ROC) curve was evaluated for each index. Different cardiovascular risk factors (smoking, prediabetes, hypertension and dyslipidemia) were evaluated. In the study population, 26.2% showed elevated SAF values. No differences in total body fat, visceral adiposity and lean body mass were detected between patients with normal and high SAF values. SAF levels showed a very slight but positive correlation with total body fat percentage (estimated by the CUN-BAE formula) and abdominal adiposity (estimated by the BRI). However, none of them had sufficient power to identify patients with high SAF levels (area under the ROC curve <0.52 in all cases). Finally, a progressive increase in SAF levels was observed in parallel with cardiovascular risk factors in the entire population and when patients with normal weight, overweight and obesity were evaluated separately. In conclusion, total obesity and visceral adiposity are not associated with a greater deposit of AGE. The elevation of AGE in obesity is related to the presence of cardiometabolic risk.

Recent Progress in the Management of Obesity

“…Having accessible tools that allow us to properly phenotype patients with obesity considering their cardiometabolic risk is essential to establish the most appropriate treatment [ 1 ]. In this sense, Sanchez et al [ 5 ] describe the use of the measurement of skin autofluorescence (SAF), a non-invasive estimator of advanced glycation endproducts (AGEs), in patients with obesity. Although SAF correlates with body fat percentage estimated with the CUN-BAE [ 6 ], it is not increased in individuals with obesity, being more related to the presence of cardiometabolic risk factors.…”

“…Although SAF correlates with body fat percentage estimated with the CUN-BAE [ 6 ], it is not increased in individuals with obesity, being more related to the presence of cardiometabolic risk factors. The authors suggest that SAF may represent a useful tool for the identification of individuals with unhealthy obesity, opening the door to new approaches to managing obesity in clinical practice [ 5 ].…”