title: Skin autofluorescence predicts cardio-renal outcome in type 1 diabetes: a longitudinal study.
abstract: BACKGROUND
  We aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascular events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D).
  
  
  METHODS
  Two hundred and forty-three patients (51.2 ± 16.7 years old) with T1D participated. SAF was measured by AGE-Reader-TM at inclusion. Macrovascular events (MVE), estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (AER) were recorded then and 4 years later. Multivariate logistic regression was used to analyze the relationships between SAF and incident MVE and renal profile 4 years later.
  
  
  RESULTS
  Patients with incident MVE had a higher SAF (p = 0.003). SAF predicted incident MVE after adjustment for age, sex, body mass index, tobacco, diabetes duration, hypertension, HbA1c, AER, eGFR (OR 4.84 [95 % CI 1.31-17.89], p = 0.018). However, this relation was no longer significant after adjustment for history of MVE. An inverse relation was found between SAF and incident eGFR (p = 0.0001). Patients with incident eGFR <60 ml/min/1.73 m(2) had a SAF higher than patients with normal eGFR. After adjustment for the previous criteria, SAF remained associated with the risk of impaired incident eGFR (OR 7.42 [95 % CI 1.59-34.65], p = 0.018). No relation was found between SAF and increased AER 4 years later.
  
  
  CONCLUSIONS
  SAF predicts MVE in patients with T1D, adjusted for cardiovascular risk factors but the most powerful predictive factor remains history of MVE. SAF also predicts eGFR impairment, adjusted for initial AER and renal function. SAF could be a useful non-invasive tool for estimating risk of cardiovascular or renal impairment in patients with T1D.
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France. flcephise@gmail.com.|Research Group Clinical Epidemiology and Medicine ECM/L.A.M.I.A, EA 4540, University of Antilles, Guadeloupe, France. flcephise@gmail.com.|Department of Diabetology-Endocrinology, University Hospital of Pointe-à-Pitre, Guadeloupe, France. flcephise@gmail.com.
authors: Fritz-Line
authors: http://orcid.org/0000-0002-4207-2868
authors: FL
authors: Vélayoudom-Céphise
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.|INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France.
authors: Kalina
authors: K
authors: Rajaobelina
authors: INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France.
authors: Catherine
authors: C
authors: Helmer
authors: INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France.
authors: Sovanndany
authors: S
authors: Nov
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.
authors: Emilie
authors: E
authors: Pupier
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.
authors: Laurence
authors: L
authors: Blanco
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.
authors: Marie
authors: M
authors: Hugo
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.
authors: Blandine
authors: B
authors: Farges
authors: INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France.
authors: Cyril
authors: C
authors: Astrugue
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.
authors: Henri
authors: H
authors: Gin
authors: Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France.|INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France.
authors: Vincent
authors: V
authors: Rigalleau
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000209:etiology*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012867:Skin / Q000378:metabolism*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D017127:Glycation End Products, Advanced
keywords: Albumin excretion rate; Estimated glomerular filtration rate; Macrovascular events; Skin autofluorescence; Type 1 diabetes