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Increased skin autofluorescence of children and adolescents with type 1 diabetes despite a well-controlled HbA1c: results from a cohort study

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ABSTRACT

Background: Early identification of children and adolescents with type 1 diabetes at high risk for development of complications is important, as early intervention may prevent further deterioration. Here we investigate the applicability of assessing skin advanced glycation end products (sAGEs) by skin autofluorescence (SAF) as a potential surrogate risk marker.

Methods: This study included a cross-sectional analysis of SAF in 77 patients with type 1 diabetes mellitus and 118 healthy controls across age categories (11–12, 13–14, 15–16, and 17–19 years old). In patients, the impact of current and historical glycated hemoglobin (HbA1c) values, age, and duration of diabetes on SAF was studied in a retrospective cohort study and analyzed with multivariable analyses.

Results: SAF was significantly and similarly higher in patients when compared with controls across all age categories (P ≤0.009). For patients, age, duration of diabetes, and current and historical HbA1c were associated with SAF in univariate analysis. Multivariate analysis showed no association between HbA1c and SAF. A subgroup of patients with a HbA1c-within-target (≤7.5 %/59 mmol/mol) were observed to have high SAF.

Conclusion: Children and adolescents with type 1 diabetes show higher SAF than controls. The presumed correlation of high HbA1c with high SAF does not exist in all patients. Thus, use of this non-invasive measure may provide a surrogate marker for diabetic complications, additional to HbA1c.

No MeSH data available.


Age-specific median skin autofluorescence (SAF) in patients with a HbA1c-above-target (>7.5 %/59 mmol/mol) and a HbA1c-within-target (≤7.5 %/59 mmol/mol), compared with controls. P-values: comparison of patients vs controls per age category by Mann-Whitney U test. Error bars: interquartile range
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Fig2: Age-specific median skin autofluorescence (SAF) in patients with a HbA1c-above-target (>7.5 %/59 mmol/mol) and a HbA1c-within-target (≤7.5 %/59 mmol/mol), compared with controls. P-values: comparison of patients vs controls per age category by Mann-Whitney U test. Error bars: interquartile range

Mentions: Figure 2 shows SAF measurements per age category for the controls, and for the patients with historical HbA1c-above-target and Hba1c-within-target. Both the overall SAF (patients: median [IQR] SAF 1.40 [1.23–1.54]; controls: mean [SD] SAF 1.14 [0.14], P <0.001) and the median SAF in the different age categories were significantly higher in patients when compared to controls (Fig. 2). In the control group, median SAF increased from 1.10 [IQR 1.00–1.20] in the age category 11–12 years to 1.40 [IQR 1.10–1.40] in the age category 17–19 years. In the patient group, the same pattern was seen: in the age category 11–12 years, median SAF was 1.24 [IQR 1.19–1.40], and in the age category 17–19 years, median SAF was 1.53 [IQR 1.48–1.66] (Fig. 2).Fig. 2


Increased skin autofluorescence of children and adolescents with type 1 diabetes despite a well-controlled HbA1c: results from a cohort study
Age-specific median skin autofluorescence (SAF) in patients with a HbA1c-above-target (>7.5 %/59 mmol/mol) and a HbA1c-within-target (≤7.5 %/59 mmol/mol), compared with controls. P-values: comparison of patients vs controls per age category by Mann-Whitney U test. Error bars: interquartile range
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5017065&req=5

Fig2: Age-specific median skin autofluorescence (SAF) in patients with a HbA1c-above-target (>7.5 %/59 mmol/mol) and a HbA1c-within-target (≤7.5 %/59 mmol/mol), compared with controls. P-values: comparison of patients vs controls per age category by Mann-Whitney U test. Error bars: interquartile range
Mentions: Figure 2 shows SAF measurements per age category for the controls, and for the patients with historical HbA1c-above-target and Hba1c-within-target. Both the overall SAF (patients: median [IQR] SAF 1.40 [1.23–1.54]; controls: mean [SD] SAF 1.14 [0.14], P <0.001) and the median SAF in the different age categories were significantly higher in patients when compared to controls (Fig. 2). In the control group, median SAF increased from 1.10 [IQR 1.00–1.20] in the age category 11–12 years to 1.40 [IQR 1.10–1.40] in the age category 17–19 years. In the patient group, the same pattern was seen: in the age category 11–12 years, median SAF was 1.24 [IQR 1.19–1.40], and in the age category 17–19 years, median SAF was 1.53 [IQR 1.48–1.66] (Fig. 2).Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: Early identification of children and adolescents with type 1 diabetes at high risk for development of complications is important, as early intervention may prevent further deterioration. Here we investigate the applicability of assessing skin advanced glycation end products (sAGEs) by skin autofluorescence (SAF) as a potential surrogate risk marker.

Methods: This study included a cross-sectional analysis of SAF in 77 patients with type 1 diabetes mellitus and 118 healthy controls across age categories (11&ndash;12, 13&ndash;14, 15&ndash;16, and 17&ndash;19 years old). In patients, the impact of current and historical glycated hemoglobin (HbA1c) values, age, and duration of diabetes on SAF was studied in a retrospective cohort study and analyzed with multivariable analyses.

Results: SAF was significantly and similarly higher in patients when compared with controls across all age categories (P &le;0.009). For patients, age, duration of diabetes, and current and historical HbA1c were associated with SAF in univariate analysis. Multivariate analysis showed no association between HbA1c and SAF. A subgroup of patients with a HbA1c-within-target (&le;7.5&nbsp;%/59&nbsp;mmol/mol) were observed to have high SAF.

Conclusion: Children and adolescents with type 1 diabetes show higher SAF than controls. The presumed correlation of high HbA1c with high SAF does not exist in all patients. Thus, use of this non-invasive measure may provide a surrogate marker for diabetic complications, additional to HbA1c.

No MeSH data available.