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Skin Autofluorescence is Associated with Early-stage Atherosclerosis in Patients with Type 1 Diabetes

View Article: PubMed Central - PubMed

ABSTRACT

Aim:: Accumulation level of fluorescent advanced glycation end products (AGEs) in the skin can be measured non-invasively as skin autofluorescence (skin AF) by autofluorescence reader. The aim of this study was to assess possible associations between skin AF and diabetic complications, especially early-stage atherosclerosis, in Japanese type 1 diabetic patients.

Methods:: Skin AF was measured by AGE reader® in 105 Japanese type 1 diabetic patients (34 men and 71 women, aged 37.4 ± 12.4 years (± SD)) and 23 age-matched healthy non-diabetic subjects. Ultrasonic carotid intima-media thickness (IMT), ankle-brachial index (ABI), and brachial ankle pulse wave velocity (baPWV) were evaluated as indices of early-stage diabetic macroangiopathy. Urinary albumin-to-creatinine ratio (UACR), the coefficient of variation of R-R intervals (CVR-R), and presence of retinopathy were also evaluated.

Results:: Skin AF values were significantly higher in type 1 diabetic patients than in healthy controls (2.07 ± 0.50 (mean ± SD) and 1.90 ± 0.26, respectively, p = 0.024). Skin AF was associated with carotid IMT (r = 0.446, p <0.001) and baPWV (r = 0.450, p <0.001), but not with ABI (r = −0.019, p = 0.8488). Notably, skin AF was an independent risk factor for IMT thickening. Similarly, skin AF was associated with log (UACR) (r = 0.194, p = 0.049) and was an independent risk factor for UACR. Furthermore, skin AF values were significantly higher in patients with diabetic retinopathy than in those without (2.21 ± 0.08 and 1.97 ± 0.06, respectively, p = 0.020).

Conclusions:: Skin AF was significantly associated with the presence and/or severity of diabetic complications and was an independent risk factor for carotid atherosclerosis.

No MeSH data available.


Association between skin AF and (A) single-point HbA1c, (B) average of past HbA1c values. Statistical analysis for association was performed using Pearson's univariate test.
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Figure 2: Association between skin AF and (A) single-point HbA1c, (B) average of past HbA1c values. Statistical analysis for association was performed using Pearson's univariate test.

Mentions: Next, to assess what factors affected skin AF values in the type 1 diabetic subjects, we analyzed associations between skin AF value and clinical parameters. Univariate regression analysis showed that skin AF was significantly associated with age, gender, smoking status, duration of diabetes, HbA1c, GA, aspartate transaminase (AST), γ-glutamyltransferase (GGT), UA, serum Creatinine, and eGFR in the type 1 diabetic subjects (Table 2, Supplementary Fig. 1A). A stepwise multivariate regression analysis including variables that were significantly associated with skin AF in univariate analysis as independent variables demonstrated that age and smoking status were independent determinants of skin AF, while HbA1c and GA were not (Table 2). Interestingly, there was also a statistically significant association between skin AF and the average HbA1c value for a long term (utmost past 10 years) in 67 subjects whose past HbA1c levels were available (Supplementary Fig. 1B). Using this average HbA1c value as an index of glycemic control, instead of the single-point HbA1c value measured at the time of enrollment, showed the average HbA1c to be an independent determinant of skin AF (β = 0.350, p = 0.002), even after adjustment for the other variables.


Skin Autofluorescence is Associated with Early-stage Atherosclerosis in Patients with Type 1 Diabetes
Association between skin AF and (A) single-point HbA1c, (B) average of past HbA1c values. Statistical analysis for association was performed using Pearson's univariate test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383547&req=5

Figure 2: Association between skin AF and (A) single-point HbA1c, (B) average of past HbA1c values. Statistical analysis for association was performed using Pearson's univariate test.
Mentions: Next, to assess what factors affected skin AF values in the type 1 diabetic subjects, we analyzed associations between skin AF value and clinical parameters. Univariate regression analysis showed that skin AF was significantly associated with age, gender, smoking status, duration of diabetes, HbA1c, GA, aspartate transaminase (AST), γ-glutamyltransferase (GGT), UA, serum Creatinine, and eGFR in the type 1 diabetic subjects (Table 2, Supplementary Fig. 1A). A stepwise multivariate regression analysis including variables that were significantly associated with skin AF in univariate analysis as independent variables demonstrated that age and smoking status were independent determinants of skin AF, while HbA1c and GA were not (Table 2). Interestingly, there was also a statistically significant association between skin AF and the average HbA1c value for a long term (utmost past 10 years) in 67 subjects whose past HbA1c levels were available (Supplementary Fig. 1B). Using this average HbA1c value as an index of glycemic control, instead of the single-point HbA1c value measured at the time of enrollment, showed the average HbA1c to be an independent determinant of skin AF (β = 0.350, p = 0.002), even after adjustment for the other variables.

View Article: PubMed Central - PubMed

ABSTRACT

Aim:: Accumulation level of fluorescent advanced glycation end products (AGEs) in the skin can be measured non-invasively as skin autofluorescence (skin AF) by autofluorescence reader. The aim of this study was to assess possible associations between skin AF and diabetic complications, especially early-stage atherosclerosis, in Japanese type 1 diabetic patients.

Methods:: Skin AF was measured by AGE reader® in 105 Japanese type 1 diabetic patients (34 men and 71 women, aged 37.4 ± 12.4 years (± SD)) and 23 age-matched healthy non-diabetic subjects. Ultrasonic carotid intima-media thickness (IMT), ankle-brachial index (ABI), and brachial ankle pulse wave velocity (baPWV) were evaluated as indices of early-stage diabetic macroangiopathy. Urinary albumin-to-creatinine ratio (UACR), the coefficient of variation of R-R intervals (CVR-R), and presence of retinopathy were also evaluated.

Results:: Skin AF values were significantly higher in type 1 diabetic patients than in healthy controls (2.07 ± 0.50 (mean ± SD) and 1.90 ± 0.26, respectively, p = 0.024). Skin AF was associated with carotid IMT (r = 0.446, p <0.001) and baPWV (r = 0.450, p <0.001), but not with ABI (r = −0.019, p = 0.8488). Notably, skin AF was an independent risk factor for IMT thickening. Similarly, skin AF was associated with log (UACR) (r = 0.194, p = 0.049) and was an independent risk factor for UACR. Furthermore, skin AF values were significantly higher in patients with diabetic retinopathy than in those without (2.21 ± 0.08 and 1.97 ± 0.06, respectively, p = 0.020).

Conclusions:: Skin AF was significantly associated with the presence and/or severity of diabetic complications and was an independent risk factor for carotid atherosclerosis.

No MeSH data available.