1
|
Martínez-García I, Cavero-Redondo I, Álvarez-Bueno C, Pascual-Morena C, Gómez-Guijarro MD, Saz-Lara A. Non-invasive skin autofluorescence as a screening method for diabetic retinopathy. Diabetes Metab Res Rev 2024; 40:e3721. [PMID: 37672325 DOI: 10.1002/dmrr.3721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/21/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023]
Abstract
Diabetic retinopathy (DR) is a public health problem and a common cause of blindness. It is diagnosed by fundus examination; however, this is a costly and time-consuming method. Non-invasive skin autofluorescence (SAF) may be an accessible, fast and simple alternative for screening and early diagnosis of DR. The aim of this study was to evaluate the accuracy of SAF as a screening method for DR. A systematic search of MEDLINE, Scopus, and Web of Science databases was performed. Random effects models for sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR), diagnostic odds ratio (dOR) value and 95% CIs were used to calculate test accuracy. In addition, hierarchical summary receiver operating characteristic curves (HSROC) were used to summarise the overall test performance. Four studies were included in the meta-analysis. Pooled sensitivity and specificity were 0.79 (95% CI 0.72-0.88; I2 = 0.0%) and 0.54 (95% CI 0.32-0.92; I2 = 97.0%), respectively. The dOR value for the diagnosis of DR using SAF was 5.11 (95% CI 1.81-14.48: I2 = 85.9%). The PRL was 2.17 (95% CI 0.62-7.64) and the NRL was 0.27 (95% CI 0.07-1.03). Heterogeneity was not relevant in sensitivity and considerable in specificity. The 95% confidence region of the HSROC included all studies. SAF as a screening test for DR shows sufficient accuracy for its use in clinical settings. SAF may be an appropriate method for DR screening, and further research is needed to recommend it as a diagnostic method.
Collapse
Affiliation(s)
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | | | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| |
Collapse
|
2
|
Borderie G, Foussard N, Larroumet A, Blanco L, Barbet-Massin MA, Ducos C, Rami-Arab L, Domenge F, Mohammedi K, Ducasse E, Caradu C, Rigalleau V. The skin autofluorescence of advanced glycation end-products relates to the development of foot ulcers in type 2 diabetes: A longitudinal observational study. J Diabetes Complications 2023; 37:108595. [PMID: 37647711 DOI: 10.1016/j.jdiacomp.2023.108595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES The long-term glycemic memory contributes to vascular complications in type 2 diabetes, including those patients with Diabetic Foot Ulcers (DFU). We investigated whether the skin autofluorescence (SAF) of Advanced Glycation End-products related to later DFUs. RESEARCH DESIGN & METHODS SAF was measured with an AGE-Reader in a retrospective cohort of patients hospitalized from 2009 to 2017 for Type 2 Diabetes. New DFUs were registered until the year 2020 and survival analyses were performed. RESULTS The 517 patients (men: 58.0 %), were 62 ± 9 years old at baseline, with a duration of diabetes of 14 ± 10 years, HbA1c: 8.7 ± 1.8 %, complications included 33.8 % macroangiopathies, 44.9 % diabetic kidney diseases and 26.7 % retinopathies. According to the IWGDF classification, the grades of risk for DFU were 0 for 43.2 %, 1 for 23.9 %, 2 for 7.2 %, and 3 for 25.7 %. During the 53 months of follow-up, 58 new DFUs occurred, mostly in patients with SAF higher than its median value (2.65 AU). Adjusted for age and sex, conventional risk factors (duration and control of diabetes, arterial hypertension, dyslipidemia, smoking), and other complications (macroangiopathy, diabetic kidney disease, retinopathy), SAF related to later DFUs. Adjusted for the IWGDF classification, SAF related to new DFUs (HR: 1.81, 95%CI:1.25-2.62). This relationship was significant for the 403 subjects without previous history of DFU (HR: 2.32, 95%CI: 1.36-3.95). SAF did not predict recurrence for patients with a previous history of DFUs. CONCLUSION SAF, a simple non-invasive marker of glycemic memory, independently predicts the occurrence of a first foot ulcer in patients with Type 2 Diabetes.
Collapse
Affiliation(s)
- Gauthier Borderie
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Ninon Foussard
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Alice Larroumet
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Laurence Blanco
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | | | - Claire Ducos
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Lila Rami-Arab
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Frédéric Domenge
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Kamel Mohammedi
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France
| | - Eric Ducasse
- Bordeaux CHU and University, Vascular Surgery, 33000 Bordeaux, France
| | - Caroline Caradu
- Bordeaux CHU and University, Vascular Surgery, 33000 Bordeaux, France
| | - Vincent Rigalleau
- Bordeaux CHU and University, Endocrinology-Diabetology-Nutrition, 33000 Bordeaux, France.
| |
Collapse
|
3
|
Etaee F, Naguib T, Goldust M, Daveluy S, Maibach H. Role of skin autofluorescence in managing renal and cardiac diseases in outpatient dermatology. Skin Res Technol 2022; 28:889-905. [PMID: 36305176 PMCID: PMC9907660 DOI: 10.1111/srt.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/26/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The accumulation of tissue-advanced glycation end products in skin results from complex and consecutive reactions and can be measured by skin autofluorescence (SAF) reader devices. This overview discusses studies evaluating the utilization of SAF in screening renal and cardiac disease. MATERIALS AND METHODS Literature search was performed using Google Scholar, PubMed, Springer, Ovid, and ScienceDirect. RESULTS SAF was an independent predictor of progression of chronic kidney disease (CKD) and was elevated in subjects on hemodialysis and peritoneal dialysis. Furthermore, SAF was significantly associated with cardiovascular events, cardiovascular mortality, and all-cause mortality in CKD patients. Other studies revealed a correlation between SAF and arterial stiffness, vascular damage, and subclinical atherosclerosis. A vegetarian diet was associated with lower SAF levels, whereas malnutrition was correlated with higher levels and increased mortality. CONCLUSIONS SAF measurement may be useful in managing renal and cardiac disease. Future studies are needed to clarify the specific role of SAF in the management of CKD and its noninvasive office utilization to identify comorbidities in inflammatory diseases, such as psoriasis.
Collapse
Affiliation(s)
- Farshid Etaee
- Department of Medicine Yale University New Haven Connecticut USA
| | - Tarek Naguib
- Department of Medicine Texas Tech Health Sciences Center Amarillo Texas USA
| | | | - Steven Daveluy
- Department of Dermatology Wayne State University Detroit Michigan USA
| | - Howard Maibach
- Department of Dermatology University of California San Francisco San Francisco California USA
| |
Collapse
|
4
|
Kadoh Y, Takayanagi Y, Sasaki J, Tanito M. Fingertip-Measured Skin Carotenoids and Advanced Glycation End Product Levels in Glaucoma. Antioxidants (Basel) 2022; 11:antiox11061138. [PMID: 35740035 PMCID: PMC9220224 DOI: 10.3390/antiox11061138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 02/07/2023] Open
Abstract
Carotenoids have antioxidant properties, and the accumulation of advanced glycation end products (AGEs) is associated with reactive oxygen species production; they have attracted attention as factors predictive of the onset and progression in glaucoma. Fingertip measurement is applicable for carotenoids and AGEs due to its noninvasiveness and simplicity. The study included 663 eyes of 663 Japanese subjects (357 males, 306 females). The mean age was 69.9 years with a standard deviation of 11.0. The study population comprised participants with primary open-angle glaucoma (PG) (n = 358), exfoliation glaucoma (EG) (n = 168), and controls (n = 137). Multivariate models suggested that lower skin carotenoid (SC) levels were associated with male gender (standard β = −0.14), AGE scores (−0.24), and a history of intraocular surgery (−0.22). Higher SC levels were associated with higher vegetable intake scores (0.21 for score 3) and diabetes (0.10). However, no association was seen between SCs and glaucoma type. AGEs levels were negatively associated with carotenoid scores (−0.25), PG (−0.15), and smoking habits (−0.26) and positively correlated with EG (0.14). SCs and AGEs were negatively correlated in the single regression analysis (r = −0.20, p < 0.0001). In conclusion, higher levels of AGEs may be candidates for systemic biomarkers of glaucoma associated with the exfoliation syndrome. SC levels can reflect self-reported daily vegetable intake.
Collapse
|
5
|
Advanced Glycations End Products in the Skin as Biomarkers of Cardiovascular Risk in Type 2 Diabetes. Int J Mol Sci 2022; 23:ijms23116234. [PMID: 35682915 PMCID: PMC9181586 DOI: 10.3390/ijms23116234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023] Open
Abstract
The incidence and prevalence of diabetes are increasing worldwide, and cardiovascular disease (CVD) is the leading cause of death among subjects with type 2 diabetes (T2D). The assessment and stratification of cardiovascular risk in subjects with T2D is a challenge. Advanced glycation end products are heterogeneous molecules produced by non-enzymatic glycation of proteins, lipids, or nucleic acids. Accumulation of advanced glycation end products is increased in subjects with T2D and is considered to be one of the major pathogenic mechanism in developing complications in diabetes. Skin AGEs could be assessed by skin autofluorescence. This method has been validated and related to the presence of micro and macroangiopathy in individuals with type 2 diabetes. In this context, the aim of this review is to critically summarize current knowledge and scientific evidence on the relationship between skin AGEs and CVD in subjects with type 2 diabetes, with a brief reference to other diabetes-related complications.
Collapse
|
6
|
Rigalleau V, Larroumet A, Mohammedi K, Baillet-Blanco L, Monlun M, Delyfer MN, Korobelnik JF, Foussard N. Comment on Gange et al. Incidence of Proliferative Diabetic Retinopathy and Other Neovascular Sequelae at 5 Years Following Diagnosis of Type 2 Diabetes. Diabetes Care 2021;44:2518-2526. Diabetes Care 2022; 45:e60. [PMID: 35245355 DOI: 10.2337/dc21-2254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Vincent Rigalleau
- Department of Endocrinology-Diabetology-Nutrition, CHU de Bordeaux, Bordeaux, France.,Department of Ophthalmology, CHU de Bordeaux, Bordeaux, France.,Bordeaux Population Health Research Center, Team LEHA, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Alice Larroumet
- Department of Endocrinology-Diabetology-Nutrition, CHU de Bordeaux, Bordeaux, France
| | - Kamel Mohammedi
- Department of Endocrinology-Diabetology-Nutrition, CHU de Bordeaux, Bordeaux, France.,Department of Ophthalmology, CHU de Bordeaux, Bordeaux, France.,Bordeaux Population Health Research Center, Team LEHA, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | | | - Marie Monlun
- Department of Endocrinology-Diabetology-Nutrition, CHU de Bordeaux, Bordeaux, France
| | - Marie-Noelle Delyfer
- Department of Ophthalmology, CHU de Bordeaux, Bordeaux, France.,Bordeaux Population Health Research Center, Team LEHA, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Jean-François Korobelnik
- Department of Ophthalmology, CHU de Bordeaux, Bordeaux, France.,Bordeaux Population Health Research Center, Team LEHA, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Ninon Foussard
- Department of Endocrinology-Diabetology-Nutrition, CHU de Bordeaux, Bordeaux, France
| |
Collapse
|
7
|
Lopez J, Gange WS, Lung K, Xu BY, Seabury SA, Toy BC. Response to Comment on Gange et al. Incidence of Proliferative Diabetic Retinopathy and Other Neovascular Sequelae at 5 Years Following Diagnosis of Type 2 Diabetes. Diabetes Care 2021;44:2518-2526. Diabetes Care 2022; 45:e61-e62. [PMID: 35245351 PMCID: PMC8918259 DOI: 10.2337/dci21-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Jennifer Lopez
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - William S Gange
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Khristina Lung
- Keck-Shaeffer Initiative for Population Health Policy, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Benjamin Y Xu
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Seth A Seabury
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA.,Keck-Shaeffer Initiative for Population Health Policy, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Brian C Toy
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| |
Collapse
|
8
|
Legiawati L, Bramono K, Indriatmi W, Yunir E, Pratama AI. Type 2 Diabetes Mellitus with Early Dry Skin Disorder: A Comparison Study Between Primary and Tertiary Care in Indonesia. Curr Diabetes Rev 2022; 18:e060821195350. [PMID: 34365924 DOI: 10.2174/1573399817666210806102212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/29/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The prevalence of Type 2 Diabetes Mellitus (T2DM) in Indonesia has continued to increase over the years. Management of T2DM is challenging across clinical settings, including primary and tertiary care. Uncontrolled T2DM puts patients at risk of the development of T2DM complications, especially early-stage dry skin that is neglected by most of the patients. This study aimed to investigate the comparison between the T2DM management profile and dry skin clinical profile of T2DM patients in primary care and tertiary care settings. METHODS The study was conducted as a cross-sectional epidemiological study by comparing T2DM patient profiles in primary and tertiary care. The data collected included sociodemographic, clinical, and laboratory data that were correlated with T2DM and early dry skin related-T2DM. This study included early dry skin within the SRRC score of 3-11 and excluded infection, ulcer, and severe erythema. RESULTS The patients in primary and tertiary care presented poorly controlled T2DM with median HbA1c levels of 7.8% and 7.6%. The patients in primary care also presented with high triglyceride, 179 mg/dl. Furthermore, several significant differences were found in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin). CONCLUSION Significant differences in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin) might be affected by the parameter of T2DM glycemic control (Blood pressure (BP), body mass index (BMI), HbA1c, random blood glucose (RBG), and triglyceride).
Collapse
Affiliation(s)
- Lili Legiawati
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jl Salemba Raya No. 6, Central Jakarta 10430, Indonesia
| | - Kusmarinah Bramono
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jl Salemba Raya No. 6, Central Jakarta 10430, Indonesia
| | - Wresti Indriatmi
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jl Salemba Raya No. 6, Central Jakarta 10430, Indonesia
| | - Em Yunir
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jl Salemba Raya No. 6, Central Jakarta 10430, Indonesia
| | - Aditya Indra Pratama
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jl Salemba Raya No. 6, Central Jakarta 10430, Indonesia
| |
Collapse
|
9
|
Wang X, Zhao X, Lian T, Wei J, Yue W, Zhang S, Chen Q. Skin autofluorescence and the complexity of complications in patients with type 2 diabetes mellitus: a cross-sectional study. BMC Endocr Disord 2021; 21:58. [PMID: 33794864 PMCID: PMC8017648 DOI: 10.1186/s12902-021-00725-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/25/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The accumulation of advanced glycation end products (AGEs) occurring in skin tissues can be measured as skin autofluorescence (SAF). Here, we assessed the correlation between SAF values and the complexity and severity of type 2 diabetes mellitus (T2DM) complications. METHODS The basic clinical information of 825 patients with T2DM was collected through an electronic system, and SAF was measured by adapting a DM-Scan, a non-invasive optical signal detector. Diabetic complications were diagnosed based on clinical criteria by experienced doctors. Linear regression analysis was used to evaluate the independent determinants of SAF, and multiple logistic regression analysis was performed to assess independent determinants that influence the severity of the complications. RESULTS SAF was significantly associated with the complexity of T2DM complications. Similarly, independent relationships between SAF and age (β = 0.389, P < 0.001), sex (β = - 2.221, P = 0.004), 2-h C-peptide (β = - 0.182, P = 0.017), aminotransferase (ALT, β = - 0.158, P = 0.041), blood creatinine (BCr, β = 0.206, P = 0.009), and fatty liver (β = 0.161, P = 0.026) were observed. With the increasing number of complications, the SAF values increased significantly after adjusting for related risk factors. The SAF values correlated with diabetic retinopathy, diabetic kidney diseases, cardiovascular disease, and diabetic peripheral neuropathy when compared with patients without any T2DM-associated complications. Moreover, the AGE-based diabetic complication risk score for each complication demonstrated a relationship with the presence or absence of certain complications. CONCLUSION SAF is an independent marker for diabetic retinopathy, diabetic kidney diseases, cardiovascular disease, and diabetic peripheral neuropathy, and it is also a predictor of the complexity of T2DM complications. Moreover, the diabetic complication risk score is capable of predicting the risk of diabetic complications in patients with T2DM.
Collapse
Affiliation(s)
- Xian Wang
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingwang Zhao
- Department of Endocrinology, Jianyang Traditional Chinese Medicine Hospital, Chengdu, China
| | - Tingting Lian
- Department of Endocrinology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Juanjin Wei
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wanxu Yue
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Senwei Zhang
- School of Clinical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiu Chen
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
| |
Collapse
|
10
|
Rigalleau V, Foussard N, Larroumet A, Monlun M, Blanco L, Delyfer MN, Korobelnik JF, Mohammedi K. Can the skin autofluorescence predict retinopathy in diabetes? Diabet Med 2021; 38:e14499. [PMID: 33319453 DOI: 10.1111/dme.14499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Vincent Rigalleau
- Department of Endocrinology-Nutrition, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Ninon Foussard
- Department of Endocrinology-Nutrition, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Alice Larroumet
- Department of Endocrinology-Nutrition, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Marie Monlun
- Department of Endocrinology-Nutrition, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Laurence Blanco
- Department of Endocrinology-Nutrition, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Marie Noëlle Delyfer
- Department of Ophtalmology, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | | | - Kamel Mohammedi
- Department of Endocrinology-Nutrition, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| |
Collapse
|
11
|
Abstract
Advanced glycation end-products (AGEs) are heterogeneous molecules produced by the non-enzymatic glycation of proteins, lipids, or nucleic acids during hyperglycaemia. Accumulation of AGEs in the peripheral nerves has recently been proposed as an additional risk factor for the development of diabetic neuropathy (DN). The gold standard for measurement of tissue-bound AGEs is tissue biopsy. However, their assessment with the newer, fast and simple method of skin autofluorescence (sAF) has recently gained special interest by virtue of its non-invasive, highly reproducible nature and its acceptable correlation with the reference method of skin biopsy. Accumulation of tissue AGEs evaluated by sAF has been shown to independently correlate with DN. Importantly, increasing evidence underscores their potential value as early biomarkers of the latter. Further important associations include diabetic nephropathy, diabetic retinopathy and cardiovascular autonomic neuropathy. However, the value of the implementation of screening with skin AGEs for DN remains unclear. The aim of the present review is to critically summarise current evidence on the association between skin AGEs and diabetic microvascular complications, with a particular emphasis on diabetic neuropathy, and to note the most important limitations of existing knowledge. Longer follow-up studies are also highly anticipated to clarify its role and provide data on patient selection and cost-effectiveness.
Collapse
Affiliation(s)
- Stella Papachristou
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, G. Kondyli 22c, 68100, Alexandroupolis, Greece
| | - Kalliopi Pafili
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, G. Kondyli 22c, 68100, Alexandroupolis, Greece
| | - Nikolaos Papanas
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, G. Kondyli 22c, 68100, Alexandroupolis, Greece.
| |
Collapse
|
12
|
Shirakami T, Yamanaka M, Fujihara J, Matsuoka Y, Gohto Y, Obana A, Tanito M. Advanced Glycation End Product Accumulation in Subjects with Open-Angle Glaucoma with and without Exfoliation. Antioxidants (Basel) 2020; 9:E755. [PMID: 32824189 PMCID: PMC7465686 DOI: 10.3390/antiox9080755] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022] Open
Abstract
Advanced glycation end products (AGEs), which are the products of a non-enzymatic reaction between reducing sugars and other macromolecules, are critical in aging, as well as metabolic and degenerative diseases. To assess the involvement of AGEs in glaucoma, skin autofluorescence (sAF) level, which is a measurement of AGEs' accumulation, was compared among Japanese patients with glaucoma (316 with primary open-angle glaucoma (PG) and 127 exfoliation syndrome and glaucoma (EG)) and controls (133 nonglaucomatous controls) (mean age 71.6 ± 12.8 years, 254 men and 322 women). The sAF values were estimated from the middle fingertip using a 365 nm light-emitting diode for excitation and detection at 440 nm emission light. The estimated AGE values (arbitrary unit) were 0.56 ± 0.15, 0.56 ± 0.11, and 0.61 ± 0.11 in the control, PG, and EG groups, respectively (p < 0.0001, analysis of variance); and were significantly higher in the EG group than the control (p = 0.0007) and PG (p < 0.0001) groups. After adjustment for various demographic parameters by multivariate analyses, male sex (standard β = 0.23), EG (0.19), and diabetes (0.09) were associated with higher AGE levels; PG (-0.18) and smoking (-0.19) were associated with lower AGE levels. Age, visual acuity, intraocular pressure, glaucoma medications, lens status, and systemic hypertension were not associated with AGEs. The high AGE level in EG suggested that specific oxidation and glycation mechanisms underlie the glaucoma pathogenesis associated with pseudoexfoliation syndrome.
Collapse
Affiliation(s)
- Tomoki Shirakami
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
| | - Mikihiro Yamanaka
- Laboratory of Food and Regulation Biology, School of Agriculture, Tokai University, Kumamoto 862-8652, Japan;
| | - Jo Fujihara
- Division of Ophthalmology, Matsue Red Cross Hospital, Matsue 690-8506, Japan; (J.F.); (Y.M.)
| | - Yotaro Matsuoka
- Division of Ophthalmology, Matsue Red Cross Hospital, Matsue 690-8506, Japan; (J.F.); (Y.M.)
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan; (Y.G.); (A.O.)
| | - Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan; (Y.G.); (A.O.)
| | - Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
| |
Collapse
|
13
|
Osawa S, Katakami N, Sato I, Ninomiya H, Omori K, Yamamoto Y, Takahara M, Miyashita K, Sakamoto F, Kawamori D, Matsuoka T, Shimomura I. Skin autofluorescence is associated with vascular complications in patients with type 2 diabetes. J Diabetes Complications 2018; 32:839-844. [PMID: 30099985 DOI: 10.1016/j.jdiacomp.2018.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 01/27/2023]
Abstract
AIMS Tissue accumulatedadvanced glycation end products (AGEs) can be evaluated non-invasively by an autofluorescence reader as skin autofluorescence (skin AF)·The present study investigated whether skin AF is associated with diabetic micro- and macroangiopathies in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS Skin AF was measured in 193 enrolled Japanese patients with T2DM and 24 enrolled healthy non-diabetic subjects by using the AGE reader®. Diabetic micro- and macroangiopathies were evaluated in the T2DM patients. RESULTS Skin AF was significantly increased in patients with T2DM than in age- and sex-matched non-diabetic controls (2.35 ± 0.51 [mean ± SD] and 1.91 ± 0.29, respectively, p = 0.001). In subjects with T2DM, skin AF was associated with age, pack-years of smoking, and eGFR (estimated glomerular filtration rate) independently. Skin AF was significantly increased in patients with diabetic retinopathy, neuropathy, nephropathy, and macroangiopathy than in those without them, and significantly associated with the number of diabetic complications. Moreover, skin AF was an independent predictor for diabetic retinopathy, neuropathy, and nephropathy but not macroangiopathy, after adjusting for major traditional risk factors. CONCLUSIONS Skin AF is an independent predictor for diabetic retinopathy, neuropathy and nephropathy in Japanese patients with T2DM.
Collapse
Affiliation(s)
- Saeko Osawa
- Department of Metabolic Medicine, Osaka Kaisei Hospital, Osaka, Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Ihoko Sato
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroyo Ninomiya
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuo Omori
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuichi Yamamoto
- Department of Metabolic Medicine, Osaka Police Hospital, Osaka, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuyuki Miyashita
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Fumie Sakamoto
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Dan Kawamori
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Medical Education Center, Faculty of Medicine, Osaka University, Osaka, Japan
| | - Takaaki Matsuoka
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
14
|
Simó-Servat O, Planas A, Ciudin A, Simó R, Hernández C. Assessment of advanced glycation end-products as a biomarker of diabetic outcomes. ACTA ACUST UNITED AC 2018; 65:540-545. [PMID: 30077632 DOI: 10.1016/j.endinu.2018.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/05/2018] [Accepted: 06/05/2018] [Indexed: 12/21/2022]
Abstract
There are substantial differences in the onset and severity of diabetes complications that are not fully explained by HbA1c levels and other risk factors. HbA1c is the gold standard for assessing metabolic control, but has limited value to identify patients at risk of developing diabetic complications. The main disadvantage of HbA1c is that it does not provide information about glycemic variability and does not reflect long-term exposure to hyperglycemia. One of the main pathogenetic mechanisms of diabetic complications is the generation and accumulation of advanced glycation end-products (AGEs). Based on its fluorescence properties, AGEs may be measured in tissues such as the skin or lens. These non-invasive measurements of AGE accumulation may be considered as promising biomarkers of late diabetic complications, and our objective is to summarize the available evidence supporting this statement. However, further translational research and prospective clinical trials are needed before these new biomarkers may be incorporated into clinical practice.
Collapse
Affiliation(s)
- Olga Simó-Servat
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain.
| | - Alejandra Planas
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute Barcelona, Spain
| | - Andreea Ciudin
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| |
Collapse
|
15
|
Sánchez E, Lecube A, Betriu À, Hernández C, López-Cano C, Gutiérrez-Carrasquilla L, Kerkeni M, Yeramian A, Purroy F, Pamplona R, Farràs C, Fernández E, Barbé F, Simó R, Hernández M, Rius F, Polanco D, de la Torre MS, Torres G, Godoy P, Portero-Otin M, Jové M, Colàs-Compàs L, Benabdelhak I, Miquel E, Ortega M, Valdivielso JM, Bermúdez M, Martínez-Alonso M. Subcutaneous advanced glycation end-products and lung function according to glucose abnormalities: The ILERVAS Project. DIABETES & METABOLISM 2018; 45:595-598. [PMID: 29706471 DOI: 10.1016/j.diabet.2018.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 12/17/2022]
Affiliation(s)
- E Sánchez
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain
| | - A Lecube
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - À Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - C Hernández
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Endocrinology and Nutrition Department, University Hospital Vall d'Hebron, Diabetes and Metabolism Research Unit, VHIR, Autonomous University of Barcelona, Barcelona, Spain
| | - C López-Cano
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain
| | - L Gutiérrez-Carrasquilla
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain
| | - M Kerkeni
- Higher Institute of Biotechnology, Laboratory of Biochemistry, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - A Yeramian
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain
| | - F Purroy
- Stroke Unit, University Hospital Arnau de Vilanova, Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | - R Pamplona
- Metabolic Pathophysiology Group, IRBLleida, University of Lleida, Lleida, Spain
| | - C Farràs
- Borges Blanques Primary Health Care Unit, Borges Blanques, Lleida, Spain
| | - E Fernández
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - F Barbé
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, University Hospital Arnau de Vilanova, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - R Simó
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Endocrinology and Nutrition Department, University Hospital Vall d'Hebron, Diabetes and Metabolism Research Unit, VHIR, Autonomous University of Barcelona, Barcelona, Spain.
| | | | - M Hernández
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - F Rius
- Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism research group (ODIM), IRBLleida, University of Lleida, Lleida, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - D Polanco
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, University Hospital Arnau de Vilanova, Lleida, Spain
| | - M S de la Torre
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, University Hospital Arnau de Vilanova, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - G Torres
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, University Hospital Arnau de Vilanova, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - P Godoy
- Respiratory Department, University Hospital Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, IRBLleida, University of Lleida, University Hospital Arnau de Vilanova, Lleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - M Portero-Otin
- Metabolic Pathophysiology Group, IRBLleida, University of Lleida, Lleida, Spain
| | - M Jové
- Metabolic Pathophysiology Group, IRBLleida, University of Lleida, Lleida, Spain
| | - L Colàs-Compàs
- Stroke Unit, University Hospital Arnau de Vilanova, Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | - I Benabdelhak
- Stroke Unit, University Hospital Arnau de Vilanova, Clinical Neurosciences Group, IRBLleida, University of Lleida, Lleida, Spain
| | - E Miquel
- Borges Blanques Primary Health Care Unit, Borges Blanques, Lleida, Spain
| | - M Ortega
- Borges Blanques Primary Health Care Unit, Borges Blanques, Lleida, Spain
| | - J M Valdivielso
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - M Bermúdez
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| | - M Martínez-Alonso
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA V&R), University Hospital Arnau de Vilanova, Vascular and Renal Translational Research Group, IRBLleida, University of Lleida, Lleida, Spain
| |
Collapse
|