Advanced glycation end products assessed by skin autofluorescence in type 1 diabetics are associated with nephropathy, but not retinopathy.
OBJECTIVE
Advanced glycation end products (AGEs) are thought to play a central role in the pathogenesis of diabetes complications. For this reason, a non-invasive tool using skin autofluorescence (AF) quantification that correlates with levels of tissue AGEs has been developed. The present study aimed to assess whether or not skin AF is associated with microvascular complications in patients with type 1 diabetes (T1D).


METHODS
All consecutive patients with T1D (n=133) had three AF measures taken on the forearm, using illumination with a fluorescent tube, all on the same day after breakfast or lunch. Potential associations between skin AF levels and microvascular complications, age, diabetes duration and health status were then assessed using a multivariate linear-regression model.


RESULTS
On age-adjusted analyses, diabetes duration, retinopathy, nephropathy and neuropathy were significantly associated with skin AF levels (all P<0.001). AF levels increased significantly with severity in both retinopathy and nephropathy (P<0.001). After adjusting for age, diabetes duration, HbA(1c), smoking, retinopathy, nephropathy and neuropathy, the association of AF levels remained significant with nephropathy and neuropathy, but not with retinopathy and diabetes duration.


CONCLUSIONS
This study suggests an independent association between skin AF levels and diabetic nephropathy and neuropathy, but not retinopathy, in T1D patients. Prospective studies are needed to confirm the ability of skin AF levels to predict microangiopathy.
Endocrinology Department, Edouard Herriot Hospital, Lyon, France.
S
S
Chabroux
F
F
Canouï-Poitrine
S
S
Reffet
G
G
Mills-Joncour
E
E
Morelon
C
C
Colin
C
C
Thivolet
D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000378:metabolism*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D017127:Glycation End Products, Advanced / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012867:Skin / Q000737:chemistry / Q000378:metabolism*; D013050:Spectrometry, Fluorescence / Q000379:methods
D017127:Glycation End Products, Advanced