Skin autofluorescence predicts incident type 2 diabetes, cardiovascular disease and mortality in the general population

Abstract

Aims/hypothesisEarlier studies have shown that skin autofluorescence measured with an AGE reader estimates the accumulation of AGEs in the skin, which increases with ageing and is associated with the metabolic syndrome and type 2 diabetes. In the present study, we examined whether the measurement of skin autofluorescence can predict 4 year risk of incident type 2 diabetes, cardiovascular disease (CVD) and mortality in the general population.MethodsFor this prospective analysis, we included 72,880 participants of the Dutch Lifelines Cohort Study, who underwent baseline investigations between 2007 and 2013, had validated baseline skin autofluorescence values available and were not known to have diabetes or CVD. Individuals were diagnosed with incident type 2 diabetes by self-report or by a fasting blood glucose ≥7.0 mmol/l or HbA1c ≥48 mmol/mol (≥6.5%) at follow-up. Participants were diagnosed as having incident CVD (myocardial infarction, coronary interventions, cerebrovascular accident, transient ischaemic attack, intermittent claudication or vascular surgery) by self-report. Mortality was ascertained using the Municipal Personal Records Database.ResultsAfter a median follow-up of 4 years (range 0.5–10 years), 1056 participants (1.4%) had developed type 2 diabetes, 1258 individuals (1.7%) were diagnosed with CVD, while 928 (1.3%) had died. Baseline skin autofluorescence was elevated in participants with incident type 2 diabetes and/or CVD and in those who had died (all p < 0.001), compared with individuals who survived and remained free of the two diseases. Skin autofluorescence predicted the development of type 2 diabetes, CVD and mortality, independent of several traditional risk factors, such as the metabolic syndrome, glucose and HbA1c.Conclusions/interpretationThe non-invasive skin autofluorescence measurement is of clinical value for screening for future risk of type 2 diabetes, CVD and mortality, independent of glycaemic measures and the metabolic syndrome.Electronic supplementary materialThe online version of this article (10.1007/s00125-018-4769-x) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

The association of skin autofluorescence with cardiovascular events and all-cause mortality in persons with chronic kidney disease stage 3: A prospective cohort study

“…With the benefit of a longer observation period resulting in a greater number of outcome events, we have confirmed that higher baseline SAF and increase in SAF over 1 year are independent predictors of CVEs and ACM in early stage CKD after adjustment for traditional risk factors and, importantly, also CRP. One study has reported that higher SAF predicted incident diabetes, CVEs, and ACM in a large cohort enrolled from the general population [20].…”

Role of Advanced Glycation Endproduct (AGE)-Receptor for Advanced Glycation Endproduct (RAGE) Axis in Cardiovascular Disease and Its Therapeutic Intervention

“…54 In a median 4-year follow-up study of more than 70,000 participants without diabetes or CVD, SAF was shown to predict the development of type 2 diabetes, CVD, and death, independently of classical risk factors. 55 Accumulation of CML increases in the atrial appendage of patients with atrial fibrillation, which is associated with severity of fibrosis in both diabetic and non-diabetic subjects. 56,57…”

Pentosidine Is Associated With Cortical Bone Geometry and Insulin Resistance in Otherwise Healthy Children

“…Noninvasive measures of AGEs such as SAF might be useful in the pediatric setting. Recently, SAF was shown to predict future type 2 diabetes and cardiovascular disease risk irrespective of metabolic health, supporting the utility of this measure and the subclinical effects of AGEs on health. As indicated above, we did not perform a comprehensive evaluation of cardiovascular and metabolic health; however, our results involving the relationship between pentosidine and insulin resistance support future work in this area.…”