title: Higher skin autofluorescence in young people with Type 1 diabetes and microvascular complications.
abstract: To test the hypothesis that non-invasive skin autofluorescence, a measure of advanced glycation end products, would provide a surrogate measure of long-term glycaemia and be associated with early markers of microvascular complications in adolescents with Type 1 diabetes.
  
  
  
  Forearm skin autofluorescence (arbitrary units) was measured in a cross-sectional study of 135 adolescents with Type 1 diabetes [mean ± sd age 15.6 ± 2.1 years, diabetes duration 8.7 ± 3.5 years, HbA1c72 ± 16 mmol/mol (8.7 ± 1.5%)]. Retinopathy, assessed using seven-field stereoscopic fundal photography, was defined as ≥1 microaneurysm or haemorrhage. Cardiac autonomic function was measured by standard deviation of consecutive RR intervals on a 10-min continuous electrocardiogram recording, as a measure of heart rate variability.
  
  
  
  Skin autofluorescence was significantly associated with age (R2= 0.15; P < 0.001). Age- and gender-adjusted skin autofluorescence was associated with concurrent HbA1c(R2= 0.32; P < 0.001) and HbA1cover the previous 2.5-10 years (R2= 0.34-0.43; P < 0.002). Age- and gender-adjusted mean skin autofluorescence was higher in adolescents with retinopathy vs those without retinopathy [mean 1.38 (95% CI 1.29, 1.48) vs 1.22 (95% CI 1.17, 1.26) arbitrary units; P = 0.002]. In multivariable analysis, retinopathy was significantly associated with skin autofluorescence, adjusted for duration (R2= 0.19; P = 0.03). Cardiac autonomic dysfunction was also independently associated with skin autofluorescence (R2= 0.11; P = 0.006).
  
  
  
  Higher skin autofluorescence is associated with retinopathy and cardiac autonomic dysfunction in adolescents with Type 1 diabetes. The relationship between skin autofluorescence and previous glycaemia may provide insight into metabolic memory. Longitudinal studies will determine the utility of skin autofluorescence as a non-invasive screening tool to predict future microvascular complications.
authors: Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Westmead, Australia.|Discipline of Child and Adolescent Health, University of Sydney, Westmead, Australia.
authors: Y H
authors: YH
authors: Cho
authors: Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Westmead, Australia.|Discipline of Child and Adolescent Health, University of Sydney, Westmead, Australia.|School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors: M E
authors: ME
authors: Craig
authors: NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia.
authors: A S
authors: AS
authors: Januszewski
authors: Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Westmead, Australia.|Discipline of Child and Adolescent Health, University of Sydney, Westmead, Australia.
authors: P
authors: P
authors: Benitez-Aguirre
authors: Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Westmead, Australia.
authors: S
authors: S
authors: Hing
authors: NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia.
authors: A J
authors: AJ
authors: Jenkins
authors: Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Westmead, Australia.|Discipline of Child and Adolescent Health, University of Sydney, Westmead, Australia.
authors: K C
authors: KC
authors: Donaghue
mesh_terms: D000293:Adolescent; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005654:Fundus Oculi; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D008297:Male; D000071071:Microaneurysm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D015999:Multivariate Analysis; D061848:Optical Imaging; D012166:Retinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D012867:Skin / Q000098:blood supply / Q000000981:diagnostic imaging*
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human