title: Skin intrinsic fluorescence is associated with coronary artery disease in individuals with long duration of type 1 diabetes.
abstract: OBJECTIVE
  Skin intrinsic fluorescence (SIF) reflects many factors, including the presence of certain advanced glycation end products. We investigated whether SIF was associated with coronary artery disease (CAD) in type 1 diabetes and whether this relationship was independent of renal disease.
  
  
  METHODS
  SIF was measured in 112 subjects from the Pittsburgh Epidemiology of Diabetes Complications (EDC) study and 60 from MedStar Health Research Institute when mean age and diabetes duration were 48 and 36 years, respectively. Cumulative glycemic exposure (updated mean A1C) represented a mean of 18 years' follow-up in EDC and 10.3 in MedStar.
  
  
  RESULTS
  Of the 172 participants, 30 had CAD (15 male and 15 female). SIF levels were higher in those with CAD (P < 0.0001). SIF was strongly associated with CAD (odds ratio [OR] 3.5 [95% CI 2.1-6.1]). After age, duration, and updated mean A1C were controlled for, SIF remained associated with CAD (2.4 [1.3-4.4]), more strongly in men (5.6 [2.1-14.6]) than in women (1.4 [0.61-3.3]). As there was no significant sex interaction, further analyses were conducted combining the sexes. Further accounting for sex and nephropathy status did not improve the model fit, though with nephropathy in the model, the OR for SIF was reduced to 1.7 (95% CI 0.89-3.4).
  
  
  CONCLUSIONS
  SIF has a significant cross-sectional association with CAD. This association is strongly linked to age and duration and, to a lesser degree, to mean A1C and renal disease. SIF therefore may be a useful overall marker of CAD risk in type 1 diabetes.
authors.affiliation: Division of Epidemiology, Vanderbilt University, Nashville, TN, USA.
authors.forename: Baqiyyah N
authors.initials: BN
authors.lastname: Conway
authors.forename: Vanita R
authors.initials: VR
authors.lastname: Aroda
authors.forename: John D
authors.initials: JD
authors.lastname: Maynard
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Matter
authors.forename: Stephen
authors.initials: S
authors.lastname: Fernandez
authors.forename: Robert E
authors.initials: RE
authors.lastname: Ratner
authors.forename: Trevor J
authors.initials: TJ
authors.lastname: Orchard
mesh_terms: D003324:Coronary Artery Disease / Q000378:metabolism / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005453:Fluorescence; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D012867:Skin / Q000473:pathology; D013050:Spectrometry, Fluorescence
chemical_list: D006442:Glycated Hemoglobin