title: Advanced glycation end products, measured as skin autofluorescence, during normal pregnancy and pregnancy complicated by diabetes mellitus.
abstract: BACKGROUND
  Advanced glycation end products (AGEs) accumulate with age and in diabetes mellitus (DM). AGEs can be measured by the AGE Reader (DiagnOptics Technologies BV, Groningen, The Netherlands) using skin autofluorescence (SAF). SAF is related to chronic diabetes complications. In a previous study we reported that SAF is comparable in patients with gestational DM (GDM) and controls at 27 weeks of gestation. In the current study we investigated SAF at multiple time points during pregnancy in pregnancies complicated by DM (type 1 or type 2) or GDM and in controls. Furthermore, the relation between SAF levels and adverse pregnancy outcomes was investigated.
  
  
  METHODS
  In this single-center prospective observational study SAF was measured during pregnancy from 26 gestational weeks onward in 79 GDM patients, 21 patients with preexistent DM (type 1 or type 2), and 55 women without diabetes. Adverse pregnancy outcomes were recorded.
  
  
  RESULTS
  SAF decreased slightly but significantly (β = -0.018) during normal pregnancy but not in pregnancies complicated with hyperglycemia. At the end of pregnancy SAF was higher in patients with preexistent DM (1.91 arbitrary [AU] units) compared with patients with GDM (1.71 AU) or normal pregnancy (1.66 AU) but did not differ between the latter two groups. SAF was not related to adverse pregnancy outcomes.
  
  
  CONCLUSIONS
  The decrease in SAF during normal pregnancy could be the result of physiological changes. Because SAF was not related to adverse pregnancy outcomes, it is unlikely that the AGE Reader will be of use in daily clinical practice for GDM patients as a marker for identifying high-risk pregnancy outcomes.
authors.affiliation: Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. w.l.greven@umcutrecht.nl
authors.forename: Wendela L
authors.initials: WL
authors.lastname: de Ranitz-Greven
authors.forename: Lotte
authors.initials: L
authors.lastname: Kaasenbrood
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Poucki
authors.forename: Jeanette
authors.initials: J
authors.lastname: Hamerling
authors.forename: Dieuwke C
authors.initials: DC
authors.lastname: Bos
authors.forename: Gerard H A
authors.initials: GH
authors.lastname: Visser
authors.forename: Douwe H
authors.initials: DH
authors.lastname: Biesma
authors.forename: Joline W J
authors.initials: JW
authors.lastname: Beulens
authors.forename: Harold W
authors.initials: HW
authors.lastname: de Valk
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D061848:Optical Imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood* / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012867:Skin / Q000378:metabolism*
chemical_list: D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; C517652:hemoglobin A1c protein, human