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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

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 (11–12, 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.


Related in: MedlinePlus

Correlation between historical HbA1c and skin autofluorescence (SAF) in children and adolescents with type 1 diabetes. amean SAF of controls + 1 SD. bmean SAF of controls -1SD. cHbA1c-within-target (≤7.5 %/59 mmol/mol) vs HbA1c-above-target (>7.5 %/59 mmol/mol)
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Fig3: Correlation between historical HbA1c and skin autofluorescence (SAF) in children and adolescents with type 1 diabetes. amean SAF of controls + 1 SD. bmean SAF of controls -1SD. cHbA1c-within-target (≤7.5 %/59 mmol/mol) vs HbA1c-above-target (>7.5 %/59 mmol/mol)

Mentions: Figure 3 shows the association between historical HbA1c and SAF. The Spearman correlation coefficient between historical HbA1c and SAF was 0.292 (P = 0.012). Figure 3 also shows that 11 patients with a historical HbA1c-within-target had an elevated SAF >1.28 (mean SAF of controls + 1 SD), whereas 1 patient with a historical HbA1c-above-target had a decreased SAF <1.00 (mean SAF of controls −1 SD).Fig. 3


Increased skin autofluorescence of children and adolescents with type 1 diabetes despite a well-controlled HbA1c: results from a cohort study
Correlation between historical HbA1c and skin autofluorescence (SAF) in children and adolescents with type 1 diabetes. amean SAF of controls + 1 SD. bmean SAF of controls -1SD. cHbA1c-within-target (≤7.5 %/59 mmol/mol) vs HbA1c-above-target (>7.5 %/59 mmol/mol)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Correlation between historical HbA1c and skin autofluorescence (SAF) in children and adolescents with type 1 diabetes. amean SAF of controls + 1 SD. bmean SAF of controls -1SD. cHbA1c-within-target (≤7.5 %/59 mmol/mol) vs HbA1c-above-target (>7.5 %/59 mmol/mol)
Mentions: Figure 3 shows the association between historical HbA1c and SAF. The Spearman correlation coefficient between historical HbA1c and SAF was 0.292 (P = 0.012). Figure 3 also shows that 11 patients with a historical HbA1c-within-target had an elevated SAF >1.28 (mean SAF of controls + 1 SD), whereas 1 patient with a historical HbA1c-above-target had a decreased SAF <1.00 (mean SAF of controls −1 SD).Fig. 3

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.


Related in: MedlinePlus