title: Skin intrinsic fluorescence is associated with hemoglobin A(1c )and hemoglobin glycation index but not mean blood glucose in children with type 1 diabetes.
abstract: OBJECTIVE
  To evaluate the relationship between skin advanced glycation end products (sAGEs) with mean blood glucose (MBG), hemoglobin A(1c) (HbA(1c)), and MBG-independent, between-patient differences in HbA(1c) among children with type 1 diabetes.
  
  
  METHODS
  Children aged 5 to 20 years with type 1 diabetes of at least 1 year duration participated. At a clinic visit, sAGE was estimated noninvasively by measurement of skin intrinsic fluorescence (SIF). SIF data were adjusted to correct for variation in skin pigmentation. MBG-independent, between-patient differences in HbA(1c) were examined by statistically controlling HbA(1c) for MBG or alternatively by use of a hemoglobin glycation index (HGI). Results were similar whether HbA(1c), MBG, and HGI were analyzed as single values from the time of the SIF examination visit or as the mean values from all available visits of the patient.
  
  
  RESULTS
  HbA(1c) was correlated with MBG (r = 0.5; P < 0.001; n = 110). HbA(1c) and HGI, but not MBG, were statistically associated with SIF after adjustment for age, duration of diabetes, race, sex, and BMI z-score. SIF increased with age and duration of diabetes and was higher in girls than boys.
  
  
  CONCLUSIONS
  sAGE levels estimated by SIF increase with age, duration of diabetes, and female sex. sAGE is correlated with MBG-independent biological variation in HbA(1c), but not with MBG itself. These results suggest that factors besides MBG that influence HbA(1c) levels also contribute to accumulation of sAGE.
authors.affiliation: Department of Pediatric Endocrinology and Diabetes, Louisiana State University Health SciencesCenter, New Orleans, LA, USA.
authors.forename: Dania L
authors.initials: DL
authors.lastname: Felipe
authors.forename: James M
authors.initials: JM
authors.lastname: Hempe
authors.forename: Shuqian
authors.initials: S
authors.lastname: Liu
authors.forename: Nate
authors.initials: N
authors.lastname: Matter
authors.forename: John
authors.initials: J
authors.lastname: Maynard
authors.forename: Carmen
authors.initials: C
authors.lastname: Linares
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Chalew
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D005260:Female; D005453:Fluorescence; D006442:Glycated Hemoglobin / Q000378:metabolism*; D017127:Glycation End Products, Advanced / Q000378:metabolism; D006801:Humans; D008297:Male; D012867:Skin / Q000378:metabolism*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced