title: Association of Skin Intrinsic Fluorescence with Retinal Microvascular Complications of Long Term Type 1 Diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy.
abstract: To determine the association between skin intrinsic fluorescence (SIF), a noninvasive measure of advanced glycation endproducts and oxidative stress in skin, and retinal microvascular complications of long duration type 1 diabetes, proliferative diabetic retinopathy (PDR) and macular edema.
  
  
  
  A cross-sectional cohort study of persons with type 1 diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) who participated in a 32-year follow-up examination in 2012-2014. Subjects underwent a physical examination, answered a health questionnaire, and had fundus photographs taken. SIF was measured on the underside of the left forearm near the elbow with the SCOUT DS®skin fluorescence spectrometer. Two representative SIF measures were used for these analyses: SIF01 excited by an LED centered at 375 nm with correction factors Kx= 0.6 and Km= 0.2 and SIF15 excited by an LED centered at 456 nm with correction factors Kx= 0.4 and Km= 0.9.
  
  
  
  The 414 participants had mean diabetes duration of 42.2 years (standard deviation 6.8 years, range 32.9-67.9 years). PDR was statistically significantly associated (p < 0.05) with both SIF measures in multivariate models including other relevant factors (odds ratio [OR] = 1.17 for SIF01 and 1.20 for SIF15).
  
  
  
  Skin intrinsic fluorescence measures are independently associated with PDR in the WESDR. Incidence information is needed to evaluate whether there is a causal relationship.
authors.affiliation: a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA.
authors.forename: Barbara E K
authors.initials: BEK
authors.lastname: Klein
authors.affiliation: a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA.
authors.forename: Kayla L
authors.initials: KL
authors.lastname: Horak
authors.affiliation: b Medical Device and Diagnostics Consulting , Albuquerque , NM , USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Maynard
authors.affiliation: a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Lee
authors.affiliation: a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D002196:Capillaries / Q000473:pathology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000473:pathology*; D013050:Spectrometry, Fluorescence / Q000379:methods*; D014922:Wisconsin / Q000453:epidemiology
keywords: Advanced glycation endproducts; macular edema; nephropathy; proliferative diabetic retinopathy; skin intrinsic fluorescence