Progression of skin autofluorescence of AGEs over 4 years in patients with type 1 diabetes

Rajaobelina, Kalina; Helmer, Catherine; Vélayoudom-Céphise, Fritz-Line; Nov, S.; Farges, Blandine; Pupier, E.; Blanco, Laurence; Hugo, M; Gin, H.; Rigalleau, Vincent

doi:10.1002/dmrr.2917

Cited by 18 publications

(16 citation statements)

References 32 publications

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“… 44 In persons with type 1 diabetes, we have reported that the progression of SAF was more pronounced if diabetic nephropathy was present, and less pronounced under treatment with continuous subcutaneous insulin infusion, which suggests that reducing glucose variability may help. 45 Nephroprotection can be another track, if the high autofluorescence in CKD predicts cancer, which remains to be determined. We have reported that SAF quickly increases during an acute renal failure.…”

Section: Discussionmentioning

confidence: 99%

Skin autofluorescence predicts cancer in subjects with type 2 diabetes

Foussard

Larroumet

Rigo

et al. 2021

BMJ Open Diab Res Care

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IntroductionSubjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by measuring the skin autofluorescence. We searched whether the skin autofluorescence could predict new cancers in persons with type 2 diabetes.Research design and methodsFrom 2009 to 2015, we measured the skin autofluorescence of 413 subjects hospitalized for uncontrolled or complicated type 2 diabetes, without any history of cancer. The participants were followed for at least 1 year and the occurrences of new cancers were compared according to their initial skin autofluorescences.ResultsThe participants were mainly men (57.9%), with poorly controlled (HbA1c 72±14 mmol/mol or 8.7%±1.8%) and/or complicated type 2 diabetes. Their median skin autofluorescence was 2.6 (2.2–3.0) arbitrary units. Forty-five new cancer cases (10.9%) were registered during 4.8±2.3 years of follow-up: 75.6% of these subjects had skin autofluorescence higher than the median (χ2: p=0.001). By Cox regression analysis adjusted for age, gender, body mass index, history of smoking and renal parameters, skin autofluorescence >2.6 predicted a 2.57-fold higher risk of cancer (95% CI 1.28 to 5.19, p=0.008). This association remained significant after excluding the eight cancers that occurred in the 4 years after inclusion (OR 2.95, 95% CI 1.36 to 6.38, p=0.006). As a continuous variable, skin autofluorescence was also related to new cancers (OR 1.05, 95% CI 1.01 to 1.10, p=0.045).ConclusionsSkin autofluorescence, a potential marker of glycemic memory, predicts the occurrence of cancer in subjects with type 2 diabetes. This relation provides a new clinical argument for the role of AGEs in cancer. Their estimation by measuring the skin autofluorescence may help select subjects with diabetes in cancer screening programs.

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Section: Discussionmentioning

confidence: 99%

Skin autofluorescence predicts cancer in subjects with type 2 diabetes

Foussard

Larroumet

Rigo

et al. 2021

BMJ Open Diab Res Care

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“…The relation between sAF and the history of diabetic foot ulcers seems of especial interest, as the diabetic foot syndrome both relies on micro (neuropathy) and macroangiopathy (peripheral arterial disease). The pioneer work from Meerwaldt already mentioned a relation between sAF and diabetic neuropathy [ 25 ], which was later confirmed in T1D [ 26 ]. SAF is high in subjects with peripheral arterial disease [ 27 ], and predicts rates of amputations [ 28 ] and mortality [ 29 ].…”

Section: Discussionmentioning

confidence: 98%

Skin autofluorescence, a marker of glucose memory in type 2 diabetes

et al. 2020

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“…Below we highlight findings from two main topics: hyperglycemia and inflammation. Some studies focused on hyperglycemia's role as a major determinant for DSPN in T1DM [32], by demonstrating that prolonged hyperglycemia may lead to nerve damage by raising reactive oxygen species (ROS) concentration and oxidative stress [33,34], and enhancing the production of advanced glycation end products [35,36]. Other studies focused on the role of chronic inflammation leading to DSPN [37], some of them underlining the importance of activation of the TNF-alpha system [24,38] and the enhanced expression of pro-inflammatory cells, possibly influenced by persistent poor glycemic control [39].…”

Section: Epidemiologymentioning

confidence: 99%

Redefining distal symmetrical polyneuropathy features in type 1 diabetes: a systematic review

Galosi

Michael

et al. 2021

Acta Diabetol

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Diabetic neuropathy is among the most frequent complications of both type 1 (T1DM) and type 2 diabetes (T2DM) and commonly manifests as a distal symmetrical polyneuropathy (DSPN). Despite evidence that T1DM- and T2DM-related DSPN are separate entities, most of our knowledge on diabetic DSPN derives from studies focused on type 2 diabetes. This systematic review provides an overview of current evidence on DSPN in T1DM, including its epidemiological, pathophysiological and clinical features, along with principal diagnostic tests findings. This review included 182 clinical and preclinical studies. The results indicate that DSPN is a less frequent complication in T1DM compared with T2DM and that distinctive pathophysiological mechanisms underlie T1DM-related DSPN development, with hyperglycemia as a major determinant. T1DM-related DSPN more frequently manifests with non-painful than painful symptoms, with lower neuropathic pain prevalence compared with T2DM-associated DSPN. The overt clinical picture seems characterized by a higher prevalence of large fiber-related clinical signs (e.g., ankle reflexes reduction and vibration hypoesthesia) and to a lesser extent small fiber damage (e.g., thermal or pinprick hypoesthesia). These findings as a whole suggest that large fibers impairment plays a dominant role in the clinical picture of symptomatic T1DM-related DSPN. Nevertheless, small fiber diagnostic testing shows high diagnostic accuracy in detecting early nerve damage and may be an appropriate diagnostic tool for disease monitoring and screening.

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Progression of skin autofluorescence of AGEs over 4 years in patients with type 1 diabetes

Abstract: The skin autofluorescence of advanced glycation end-products progresses in patients with type 1 diabetes, more if they have diabetic nephropathy, less if they are treated by continuous subcutaneous insulin infusion. This progression is associated with the development of nephropathy.

Cited by 18 publications

References 32 publications

Skin autofluorescence predicts cancer in subjects with type 2 diabetes

Skin autofluorescence predicts cancer in subjects with type 2 diabetes

Skin autofluorescence, a marker of glucose memory in type 2 diabetes

Redefining distal symmetrical polyneuropathy features in type 1 diabetes: a systematic review

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