Skin autofluorescence is associated with carotid intima-media thickness, diabetic microangiopathy, and long-lasting metabolic control in type 1 diabetic patients. Results from Poznan Prospective Study

Araszkiewicz, Aleksandra; Naskręt, Dariusz; Zozulińska−Ziółkiewicz, Dorota; Piłaciński, Stanisław; Uruska, Aleksandra; Grzelka, Agata; Wegner, Małgorzata; Wierusz‐Wysocka, Bogna

doi:10.1016/j.mvr.2015.01.002

Cited by 27 publications

(20 citation statements)

References 32 publications

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“…The risk of microvascular complications like retinopathy has indeed been related more to ancient than recent HbA 1c in T1D [31]. In a previous study, we noted that SAF was better correlated with the previous years than present HbA 1c [12], in line with other authors’ findings in T1D [14, 25, 32]. Measures of skin fluorescence in the DCCT were no longer related to complications after adjustment to the mean HbA 1c [33], which suggested that the relation with complications is supported by metabolic memory, although a major part of the variance of skin fluorescence is not explained by conventional factors such as HbA 1c , age and GFR [34].…”

Section: Discussionsupporting

confidence: 88%

“…Only cross sectional studies were performed in T1D and showed that SAF was associated with subclinical markers of macroangiopathy as intima-media thickness [14] and arterial stiffness [15, 16]. Furthermore, skin fluorescence could be measured with the SCOUT DM ® (VeraLight, Inc., Albuquerque, NM) another method for assessing intra-patient skin variation irrespective of the Fitzpatrick phototype.…”

Section: Discussionmentioning

confidence: 99%

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Skin autofluorescence predicts cardio-renal outcome in type 1 diabetes: a longitudinal study

Vélayoudom-Céphise

Rajaobelina

Helmer

et al. 2016

Cardiovasc Diabetol

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BackgroundWe aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascular events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D).MethodsTwo hundred and forty-three patients (51.2 ± 16.7 years old) with T1D participated. SAF was measured by AGE-Reader-TM at inclusion. Macrovascular events (MVE), estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (AER) were recorded then and 4 years later. Multivariate logistic regression was used to analyze the relationships between SAF and incident MVE and renal profile 4 years later.ResultsPatients with incident MVE had a higher SAF (p = 0.003). SAF predicted incident MVE after adjustment for age, sex, body mass index, tobacco, diabetes duration, hypertension, HbA1c, AER, eGFR (OR 4.84 [95 % CI 1.31–17.89], p = 0.018). However, this relation was no longer significant after adjustment for history of MVE. An inverse relation was found between SAF and incident eGFR (p = 0.0001). Patients with incident eGFR <60 ml/min/1.73 m2 had a SAF higher than patients with normal eGFR. After adjustment for the previous criteria, SAF remained associated with the risk of impaired incident eGFR (OR 7.42 [95 % CI 1.59–34.65], p = 0.018). No relation was found between SAF and increased AER 4 years later.ConclusionsSAF predicts MVE in patients with T1D, adjusted for cardiovascular risk factors but the most powerful predictive factor remains history of MVE. SAF also predicts eGFR impairment, adjusted for initial AER and renal function. SAF could be a useful non-invasive tool for estimating risk of cardiovascular or renal impairment in patients with T1D.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Skin autofluorescence predicts cardio-renal outcome in type 1 diabetes: a longitudinal study

Vélayoudom-Céphise

Rajaobelina

Helmer

et al. 2016

Cardiovasc Diabetol

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“…However, the identification of AGEs in the atherosclerotic plaques of nondiabetic patients with coronary artery disease have magnified the importance of AGEs and oxidative stress in accelerating atherosclerosis 41. AGEs from long‐lived proteins such as collagens42 predict future progression of microvascular disease, progression of carotid intima‐media thickness, left ventricular mass, and the severity of coronary artery calcium 43. Accordingly, the results of our study demonstrate that levels of SAF are associated with cardiovascular events and cardiovascular mortality.…”

Section: Discussionmentioning

confidence: 62%

Skin Autofluorescence–Indicated Advanced Glycation End Products as Predictors of Cardiovascular and All‐Cause Mortality in High‐Risk Subjects: A Systematic Review and Meta‐analysis

Cavero‐Redondo

Soriano-Cano

Álvarez‐Bueno

et al. 2018

JAHA

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BackgroundChronic deposits of advanced glycation end products produced by enzymatic glycation have been suggested as predictors of atherosclerotic‐related disorders. This study aimed to estimate the relationship between advanced glycation end products indicated by skin autofluorescence levels and the risk of cardiovascular and all‐cause mortality based on data from observational studies.Methods and ResultsWe systematically searched Medline, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the Web of Science databases from their inceptions until November 2017 for observational studies addressing the association of advanced glycation end products by skin autofluorescence levels with cardiovascular and all‐cause mortality. The DerSimonian and Laird random‐effects method was used to compute pooled estimates of hazard ratios and their respective 95% confidence intervals for the risk of cardiovascular and all‐cause mortality associated with levels of advanced glycation end products by skin autofluorescence. Ten published studies were included in the systematic review and meta‐analysis. Higher skin autofluorescence levels were significantly associated with a higher pooled risk estimate for cardiovascular mortality (hazard ratio: 2.06; 95% confidence interval, 1.58–2.67), which might not be important to moderate heterogeneity (I2=34.7%; P=0.163), and for all‐cause mortality (hazard ratio: 1.91; 95% confidence interval, 1.42–2.56) with substantial heterogeneity (I2=60.8%; P=0.0.18).ConclusionsOur data suggest that skin autofluorescence levels could be considered predictors of all‐cause mortality and cardiovascular mortality in patients at high and very high risk.

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“…Cross-sectional studies have already reported a relation between the sAF and microangiopathic complications such as retinopathy and nephropathy in type 1 diabetes [10] as well as a relation with neuropathy defined by the presence of two or more signs or symptoms [17]. This relation was also found using another device that measures skin intrinsic fluorescence [18,19].…”

Section: Discussionmentioning

confidence: 79%

Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes

Rajaobelina

Farges

Nov

et al. 2016

Diabetes Metabolism Res

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Objective Advanced glycation end products (AGEs) are involved in diabetes complications. We aimed to investigate whether the accumulation of AGEs measured by skin autofluorescence (sAF) was associated with signs of diabetic peripheral neuropathy and to sensitivity, pain, motor and autonomic function 4 years later in patients with type 1 diabetes.Methods At baseline, 188 patients (age 51 years, diabetes duration 22 years) underwent skin autofluorescence measurement using the AGE Reader. Four years later, signs of diabetic peripheral neuropathy were defined as the presence of neuropathic pain and/or feet sensory loss or foot ulceration. Neurological tests were systematically performed: vibration perception threshold by neuroesthesiometry, neuropathic pain by the Douleur Neuropathique en 4 Questions score, muscle strength by dynamometry and electrochemical skin conductance. Multivariate analyses were adjusted by age, sex, height, body mass index, tobacco, HbA 1c , diabetes duration, estimated glomerular filtration rate and albumin excretion rate.Results At the 4-year follow-up, 13.8% of patients had signs of diabetic peripheral neuropathy. The baseline sAF was higher in those with signs of diabetic peripheral neuropathy (2.5 ± 0.7 vs 2.1 ± 0.5 arbitrary units (AU), p < 0.0005). In the multivariate analysis, a 1 SD higher skin autofluorescence at baseline was associated with an increased risk of signs of neuropathy (OR = 2.68, p = 0.01). All of the neurological tests were significantly altered in the highest quartile of the baseline sAF (>2.4 AU) compared with the lowest quartiles after multivariate adjustment.Conclusion This non-invasive measurement of skin autofluorescence may have a value for diabetic peripheral neuropathy in type 1 diabetes and a potential clinical utility for detection of diabetic peripheral neuropathy.

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Skin autofluorescence is associated with carotid intima-media thickness, diabetic microangiopathy, and long-lasting metabolic control in type 1 diabetic patients. Results from Poznan Prospective Study

Cited by 27 publications

References 32 publications

Skin autofluorescence predicts cardio-renal outcome in type 1 diabetes: a longitudinal study

Skin autofluorescence predicts cardio-renal outcome in type 1 diabetes: a longitudinal study

Skin Autofluorescence–Indicated Advanced Glycation End Products as Predictors of Cardiovascular and All‐Cause Mortality in High‐Risk Subjects: A Systematic Review and Meta‐analysis

Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes

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