title: Skin autofluorescence is associated with severity of vascular complications in Japanese patients with Type 2 diabetes.
abstract: OBJECTIVE
  Skin autofluorescence, a non-invasive measure of the accumulation for advanced glycation end products, has been reported to be a useful marker for diabetic vascular risks in the Caucasian population. The aim of this study was to evaluate associations between skin autofluorescence and vascular complications in non-Caucasian patients with Type 2 diabetes.
  
  
  METHODS
  Subjects in this cross-sectional study comprised 130 Japanese patients with Type 2 diabetes. Skin advanced glycation end products were assessed by skin autofluorescence using an autofluorescence reader. Association between skin autofluorescence and severity of vascular complications was evaluated.
  
  
  RESULTS
  Of the 130 patients, 60 (46.2%) had microvascular complications such as diabetic retinopathy, neuropathy and nephropathy, 10 (7.7%) had macrovascular complications and 63 (48.5%) had micro- and/or macrovascular complications. Skin autofluorescence increased with severity of vascular complications. Independent determinants of skin autofluorescence were age (β = 0.24, P < 0.01), mean HbA(1c) in previous year (β = 0.17, P = 0.03), microvascular complications (β = 0.44, P < 0.01) and macrovascular complications (β = 0.27, P < 0.01). Multiple logistic regression analysis revealed that diabetes duration (odds ratio 1.15, P < 0.01), systolic blood pressure (odds ratio 1.04, P = 0.01), skin autofluorescence (odds ratio 3.62, P = 0.01) and serum albumin (odds ratio 0.84, P < 0.01) were independent factors for the presence of vascular complications in these patients.
  
  
  CONCLUSIONS
  Skin autofluorescence had independent effects on vascular complications in Japanese patients with Type 2 diabetes. This indicates that skin advanced glycation end products are a surrogate marker for vascular risk and a non-invasive autofluorescence reader may be a useful tool to detect high-risk cases in non-Caucasian patients with diabetes.
authors.affiliation: Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima, Japan. kennichi@fmu.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Tani
authors.forename: J
authors.initials: J
authors.lastname: Asai
authors.forename: F
authors.initials: F
authors.lastname: Nemoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kusano
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashi
authors.forename: K
authors.initials: K
authors.lastname: Asahi
authors.forename: M
authors.initials: M
authors.lastname: Nakayama
authors.forename: T
authors.initials: T
authors.lastname: Miyata
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D044466:Asian People; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D005260:Female; D005453:Fluorescence; D006442:Glycated Hemoglobin / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D012867:Skin / Q000378:metabolism*; D012907:Smoking / Q000009:adverse effects*
chemical_list: D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; C517652:hemoglobin A1c protein, human