Usefulness of skin advanced glycation end products to predict coronary artery calcium score in patients with type 2 diabetes

Planas, Alejandra; Simó‐Servat, Olga; Bañeras, Jordi; Sanchez, M.E. Alamilla; García, Eva Sánchez; Ortiz, Angel; Ruiz‐Meana, Marisol; Hernández, Cristina; Ferreira‐González, Ignacio; Simó, Rafael

doi:10.1007/s00592-021-01735-5

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Previously, we provided evidence that DR is an independent predictor of subclinical CVD [19] and that SAF is a good predictor of a CACs > 400 AU (a reliable marker of coronary atherosclerosis) [10]. The current study is important because we confirm that both DR and SAF are not only related to subclinical cardiovascular disease but are also useful in predicting CV events in type 2 diabetes population.…”

Section: Discussionsupporting

confidence: 66%

“…In recent years, a simple and non-invasive method for AGEs assessment through skin autofluorescence (SAF) has been validated [8] and related to the presence of micro-and macroangiopathy in individuals with type 2 diabetes [9]. In this regard, we previously reported that SAF was a good predictor of calcium score (CACs) > 400 AU, a reliable marker of coronary atherosclerosis [10].…”

Section: Introductionmentioning

confidence: 99%

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Diabetic Retinopathy and Skin Tissue Advanced Glycation End Products Are Biomarkers of Cardiovascular Events in Type 2 Diabetic Patients

Planas

Simó‐Servat

Hernández

et al. 2021

JPM

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Risk of cardiovascular events is not homogeneous in subjects with type 2 diabetes; therefore, its early identification remains a challenge to be met. The aim of this study is to evaluate whether the presence of diabetic retinopathy and accumulation of advanced glycation end-products in subcutaneous tissue can help identify patients at high risk of cardiovascular events. For this purpose, we conducted a prospective study (mean follow-up: 4.35 years) comprising 200 subjects with type 2 diabetes with no history of clinical cardiovascular disease and 60 non-diabetic controls matched by age and sex. The primary outcome was defined as the composite of myocardial infarction, coronary revascularization, stroke, lower limb amputation or cardiovascular death. The Cox proportional hazard multiple regression analysis was used to determine the independent predictors of cardiovascular events. The patients with type 2 diabetes had significantly more cardiovascular events than the non-diabetic subjects. Apart from the classic factors such as age, sex and coronary artery calcium score, we observed that the diabetic retinopathy and advanced glycation end-products in subcutaneous tissue were independent predictors of cardiovascular events. We conclude that the diabetic retinopathy and advanced glycation end-products in subcutaneous tissue could be useful biomarkers for selecting type 2 diabetic patients in whom the screening for cardiovascular disease should be prioritized, thereby creating more personalized and cost-effective medicine.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Diabetic Retinopathy and Skin Tissue Advanced Glycation End Products Are Biomarkers of Cardiovascular Events in Type 2 Diabetic Patients

Planas

Simó‐Servat

Hernández

et al. 2021

JPM

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“…Finally, 33 case–control studies were included in this study. [ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 ] Figure 1 shows the PRISMA flowchart for this systematic review and meta-analysis. The included studies were published between 2006 and 2022 years.…”

Section: Resultsmentioning

confidence: 99%

“…[ 2 ] In a previous study, no correlation was observed between SAF and HbA1c. [ 10 ] This is due to the fact that collagen, which has a low turnover and shows hyperglycemia over a longer time period than HbA1c (10–15 years vs. 3 months, roughly), is where skin AGEs are mostly deposited. [ 56 ] Moreover, we discovered a connection between HbA1c and SAF levels in our earlier research.…”

Section: Discussionmentioning

confidence: 99%

Is skin autofluorescence a novel non-invasive marker in diabetes? A systematic review and meta-analysis of case–control studies

Sadeghi,

Hosseini,

Razavi

et al. 2023

J Res Med Sci

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Background: The advanced glycation end product (AGE) is produced from the nonenzymatic reaction between glucose and macromolecules by aging. Accumulation of AGE causes functional and structural changes in body proteins that lead to impairment of tissue protein functions. We aimed to validate AGE measurement by skin autofluorescence (SAF) in diabetes mellitus (DM) compared to the nondiabetes population. Materials and Methods: We searched the PubMed, Cochrane, and Scopus databases from their inception till September 18, 2022, for casecontrol studies measuring AGE by SAF. Nonhuman studies, as well as review articles, study proposals, editorials, case reports, or congress posters, were excluded. We used a random effects model to assess the standard mean difference (MD) of age, body mass index (BMI), HbA1c, and SAF between diabetes and nondiabetes individuals. Results: Higher SAF in DM patients indicated more accumulation of AGE compared with the nondiabetic population. Furthermore, HbA1c was considerably higher in DM patients. The MD of age, male gender, and BMI were significantly different between the DM individuals, compared with nondiabetic subjects, which can lead to altered SAF level and AGE production. There was a remarkable heterogeneity between diabetes and nondiabetes when measuring age, gender, and BMI, as well as HbA1c and SAF level. Conclusion: This study could not confirm the validity of SAF as a surrogate marker in diabetes patients. Interestingly, metabolic load and high BMI can increase SAF, considerably. Altogether, SAF could be helpful in the future as a marker for metabolic syndrome or diabetes.

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“…Coronary artery calcification score (CACs) is a common feature in advanced atherosclerosis and a powerful predictor of future cardiovascular events such as myocardial infarction [ 6 ]. Our group has recently published a study comprising 156 subjects with T2D and 52 controls, and we have demonstrated that SAF is a good and independent predictor of CACs ≥ 400 with OR 2.04 (CI 95% 1.07–3.88), p = 0.033, with area under the ROC curve of 0.77 (CI 95% 0.70–0.84) [ 85 ].…”

Section: Saf and Diabetic Macrovascular Complicationsmentioning

confidence: 99%

Advanced Glycations End Products in the Skin as Biomarkers of Cardiovascular Risk in Type 2 Diabetes

Planas

Simó‐Servat

Hernández

et al. 2022

IJMS

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The incidence and prevalence of diabetes are increasing worldwide, and cardiovascular disease (CVD) is the leading cause of death among subjects with type 2 diabetes (T2D). The assessment and stratification of cardiovascular risk in subjects with T2D is a challenge. Advanced glycation end products are heterogeneous molecules produced by non-enzymatic glycation of proteins, lipids, or nucleic acids. Accumulation of advanced glycation end products is increased in subjects with T2D and is considered to be one of the major pathogenic mechanism in developing complications in diabetes. Skin AGEs could be assessed by skin autofluorescence. This method has been validated and related to the presence of micro and macroangiopathy in individuals with type 2 diabetes. In this context, the aim of this review is to critically summarize current knowledge and scientific evidence on the relationship between skin AGEs and CVD in subjects with type 2 diabetes, with a brief reference to other diabetes-related complications.

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Usefulness of skin advanced glycation end products to predict coronary artery calcium score in patients with type 2 diabetes

Cited by 8 publications

References 30 publications

Diabetic Retinopathy and Skin Tissue Advanced Glycation End Products Are Biomarkers of Cardiovascular Events in Type 2 Diabetic Patients

Diabetic Retinopathy and Skin Tissue Advanced Glycation End Products Are Biomarkers of Cardiovascular Events in Type 2 Diabetic Patients

Is skin autofluorescence a novel non-invasive marker in diabetes? A systematic review and meta-analysis of case–control studies

Advanced Glycations End Products in the Skin as Biomarkers of Cardiovascular Risk in Type 2 Diabetes

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