Skin Autofluorescence is Associated with Early-stage Atherosclerosis in Patients with Type 1 Diabetes.
OBJECTIVE
Accumulation level of fluorescent advanced glycation end products (AGEs) in the skin can be measured non-invasively as skin autofluorescence (skin AF) by autofluorescence reader. The aim of this study was to assess possible associations between skin AF and diabetic complications, especially early-stage atherosclerosis, in Japanese type 1 diabetic patients.


METHODS
Skin AF was measured by AGE reader® in 105 Japanese type 1 diabetic patients (34 men and 71 women, aged 37.4±12.4 years (±SD)) and 23 age-matched healthy non-diabetic subjects. Ultrasonic carotid intima-media thickness (IMT), ankle-brachial index (ABI), and brachial ankle pulse wave velocity (baPWV) were evaluated as indices of early-stage diabetic macroangiopathy. Urinary albumin-to-creatinine ratio (UACR), the coefficient of variation of R-R intervals (CVR-R), and presence of retinopathy were also evaluated.


RESULTS
Skin AF values were significantly higher in type 1 diabetic patients than in healthy controls (2.07±0.50 (mean±SD) and 1.90±0.26, respectively, p=0.024). Skin AF was associated with carotid IMT (r=0.446, p＜0.001) and baPWV (r=0.450, p＜0.001), but not with ABI (r=－0.019, p=0.8488). Notably, skin AF was an independent risk factor for IMT thickening. Similarly, skin AF was associated with log (UACR) (r=0.194, p=0.049) and was an independent risk factor for UACR. Furthermore, skin AF values were significantly higher in patients with diabetic retinopathy than in those without (2.21±0.08 and 1.97±0.06, respectively, p=0.020).


CONCLUSIONS
Skin AF was significantly associated with the presence and/or severity of diabetic complications and was an independent risk factor for carotid atherosclerosis.
Department of Metabolic Medicine, Osaka University Graduate School of Medicine.
Saeko
S
Osawa
Naoto
N
Katakami
Akio
A
Kuroda
Mitsuyoshi
M
Takahara
Fumie
F
Sakamoto
Dan
D
Kawamori
Takaaki
T
Matsuoka
Munehide
M
Matsuhisa
Iichiro
I
Shimomura
D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D005260:Female; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D008297:Male; D008856:Microscopy, Fluorescence; D012307:Risk Factors; D012867:Skin / Q000378:metabolism / Q000473:pathology*
D017127:Glycation End Products, Advanced