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Sánchez E, Kerkeni M, Hernández M, Gavaldà R, Rius F, Sauret A, Torres G, Bermúdez-López M, Fernández E, Castro-Boqué E, Purroy F, Mauricio D, Farràs-Sallés C, Buti M, Godoy P, Pamplona R, Lecube A. Weak Association between Skin Autofluorescence Levels and Prediabetes with an ILERVAS Cross-Sectional Study. Nutrients 2022; 14:nu14051102. [PMID: 35268075 PMCID: PMC8912766 DOI: 10.3390/nu14051102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 02/04/2023] Open
Abstract
A large body of evidence demonstrates a relationship between hyperglycemia and increased concentrations of advanced glycation end-products (AGEs). However, there is little information about subcutaneous AGE accumulation in subjects with prediabetes, and whether or not this measurement could assist in the diagnosis of prediabetes is unclear. A cross-sectional study was conducted in 4181 middle-aged subjects without diabetes. Prediabetes (n = 1444) was defined as a glycosylated hemoglobin (HbA1c) level between 39 and 47 mmol/mol (5.7 to 6.4%), and skin autofluorescence (SAF) measurement was performed to assess AGEs. A multivariable logistic regression model and receiver operating characteristic curve were used. The cohort consisted of 50.1% women with an age of 57 [52;62] years, a BMI of 28.3 [25.4;31.6] kg/m2, and a prevalence of prediabetes of 34.5%. Participants with prediabetes showed higher SAF than control participants (2.0 [1.7;2.2] vs. 1.9 [1.7;2.2], p < 0.001). However, HbA1c was not significantly correlated with SAF levels (r = 0.026, p = 0.090). In addition, the SAF level was not independently associated with prediabetes (OR = 1.12 (0.96 to 1.30)). Finally, there was no good cutoff point for SAF to identify patients with prediabetes (AUC = 0.52 (0.50 to 0.54), sensitivity = 0.61, and 1-specificity = 0.56). Given all of this evidence, we can conclude that although there is an increase in SAF levels in participants with prediabetes, the applicability and clinical relevance of the results is low in this population.
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Affiliation(s)
- Enric Sánchez
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Mohsen Kerkeni
- Laboratory of Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Monastir 5000, Tunisia;
| | - Marta Hernández
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Ricard Gavaldà
- Amalfi Analytics, Polytechnic University of Catalonia, 08034 Barcelona, Spain;
| | - Ferran Rius
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Ariadna Sauret
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
| | - Gerard Torres
- Precision Medicine in Chronic Diseases Group, IRBLleida, 25198 Lleida, Spain;
| | - Marcelino Bermúdez-López
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Elvira Fernández
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Eva Castro-Boqué
- Vascular and Renal Translational Research Group, IRBLleida, 25198 Lleida, Spain; (M.B.-L.); (E.F.); (E.C.-B.)
- Red de Investigación Renal, Instituto de Salud Carlos III (RedinRen-ISCIII), 28029 Madrid, Spain
| | - Francisco Purroy
- Stroke Unit, Clinical Neurosciences Group, University Hospital Arnau de Vilanova, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.P.); (P.G.)
| | - Dídac Mauricio
- Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cristina Farràs-Sallés
- Applied Epidemiology Research Group, IRBLleida. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25198 Lleida, Spain; (C.F.-S.); (M.B.)
| | - Miquel Buti
- Applied Epidemiology Research Group, IRBLleida. Unitat de Suport a la Recerca Lleida, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 25198 Lleida, Spain; (C.F.-S.); (M.B.)
| | - Pere Godoy
- Stroke Unit, Clinical Neurosciences Group, University Hospital Arnau de Vilanova, IRBLleida, University of Lleida, 25198 Lleida, Spain; (F.P.); (P.G.)
| | - Reinald Pamplona
- Department of Experimental Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain;
| | - Albert Lecube
- Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain; (E.S.); (M.H.); (F.R.); (A.S.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-973-70-51-83; Fax: +34-973-70-51-89
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Paolillo FR, Mattos VS, de Oliveira AO, Guimarães FEG, Bagnato VS, de Castro Neto JC. Noninvasive assessments of skin glycated proteins by fluorescence and Raman techniques in diabetics and nondiabetics. JOURNAL OF BIOPHOTONICS 2019; 12:e201800162. [PMID: 30091532 DOI: 10.1002/jbio.201800162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/07/2018] [Indexed: 06/08/2023]
Abstract
Diabetes is a complex metabolic disease and has chronic complications. It has been considered a serious public health problem. The aim of the current study was to evaluate skin glycated proteins through fluorescence and Raman techniques. One hundred subjects were invited to participate in the study. Six volunteers did not attend due to exclusion criteria or a change of mind about participating. Therefore, 94 volunteers were grouped according to age range (20-80 years), health condition (nondiabetic, with insulin resistance [IR] and/or diabetic) and Fitzpatrick skin type (I-VI). The fluorescence spectrometer and the portable Raman spectroscopy system were used to measure glycated proteins from the skin. There was elevated skin autofluorescence in healthy middle-aged and elderly subjects, as well as in patients with IR and/or diabetes. Regarding Raman spectroscopy, changes in the skin hydration state, degradation of type I collagen and greater glycation were related for diabetes and chronological aging. Weak and positive correlation between the skin autofluorescence and the Raman peaks ratio (855/876) related to the glycated proteins was also found. Raman spectroscopy shows several bands for spectral analyses, complementing the fluorescence data. Therefore, this study contributes to understanding of the optical of human skin for noninvasive diabetes screening.
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Affiliation(s)
- Fernanda R Paolillo
- Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), São Carlos, Brazil
| | - Vicente S Mattos
- Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), São Carlos, Brazil
| | - André O de Oliveira
- Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), São Carlos, Brazil
| | - Francisco E G Guimarães
- Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), São Carlos, Brazil
| | - Vanderlei S Bagnato
- Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), São Carlos, Brazil
| | - Jarbas C de Castro Neto
- Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), São Carlos, Brazil
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Klein R, Lee KE, Maynard JD, Meuer SM, Gangnon RE, Klein BEK. Skin Intrinsic Fluorescence and Age-Related Macular Degeneration: The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 2017; 58:6328-6333. [PMID: 29242907 PMCID: PMC5742994 DOI: 10.1167/iovs.17-22382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine if skin intrinsic fluorescence (SIF), a noninvasive measure of advanced glycation endproducts and oxidative stress in skin is associated with AMD. Methods SIF was measured with the SCOUT DS skin fluorescence spectrometer in a cross-sectional cohort study of 969 persons aged 68 to 102 years from the 1181 who participated in the 25-year follow-up examination in the Beaver Dam Eye Study (BDES) in 2014 to 2016. The SCOUT DS skin fluorescence spectrometer uses five light-emitting diodes, centered at 375 nm to 456 nm. AMD was assessed by grading of digital color 45° stereoscopic fundus photographs of the macula using the Wisconsin Age-Related Maculopathy grading scheme. Analyses included logistic regression with generalized estimating equations to account for correlation between the eyes of a person. Results There were data for 1827 eyes for analyses. Early AMD was present in 22% and late AMD in 4% of the eyes. While adjusting for age, sex, smoking status, and history of cardiovascular disease, there were no significant associations of any SIF measure with any AMD or exudative AMD. SIF01 (odds ratio per 1 SD difference on the log scale, 95% confidence interval) (1.66, 1.00-2.74, P = 0.05) and SIF03 (1.81, 1.16-2.81, P = 0.008) were associated with geographic atrophy. Conclusions There was a suggestive relationship of two SIF measures, SIF01 and SIF03, using different correction factors from the excitation centered at 375 nm, with the prevalence of geographic atrophy in the BDES. Longitudinal follow-up is indicated to assess a temporal relationship.
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Affiliation(s)
- Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Kristine E Lee
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - John D Maynard
- Medical Device and Diagnostics Consulting, Albuquerque, New Mexico, United States
| | - Stacy M Meuer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Ronald E Gangnon
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.,Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
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Fokkens BT, van Waateringe RP, Mulder DJ, Wolffenbuttel BHR, Smit AJ. Skin autofluorescence improves the Finnish Diabetes Risk Score in the detection of diabetes in a large population-based cohort: The LifeLines Cohort Study. DIABETES & METABOLISM 2017; 44:424-430. [PMID: 29097003 DOI: 10.1016/j.diabet.2017.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/17/2017] [Accepted: 09/18/2017] [Indexed: 12/15/2022]
Abstract
AIM The aim of the present study was to investigate whether skin autofluorescence would improve the Finnish Diabetes Risk Score (FINDRISC) in detecting undiagnosed diabetes in a large population-based cohort. METHODS Included were participants from the Dutch LifeLines Cohort Study. Skin autofluorescence was assessed in an unselected subset of participants using the AGE Reader. After the exclusion of participants with previously diagnosed diabetes (n=1635), pregnant women (n=58) and those using corticosteroids (n=345), 79,248 subjects were eligible for analysis. Diabetes was defined as fasting plasma glucose ≥7.0mmol/L, non-fasting plasma glucose ≥11.1mmol/L or HbA1c ≥6.5% (48mmol/mol). RESULTS Diabetes was detected in 1042 participants (aged 55±12 years; 54% male). Skin autofluorescence improved the area under the receiver operating characteristic (AUROC) curve of the FINDRISC model from 0.802 to 0.811 (P<0.001). Furthermore, the addition of skin autofluorescence to FINDRISC reclassified 8-15% of all participants into more accurate risk categories (NRI: 0.080, 95% CI: 0.052-0.110). The proportion of reclassified participants was especially high (>30%) in the intermediate (1% to <5% and 5% to<10%) risk categories. When skin autofluorescence was added to a simplified model (age+body mass index), its discriminatory performance was similar to the full model+skin autofluorescence (AUROC: 0.806, P=0.062). CONCLUSION Skin autofluorescence is a non-invasive tool that can be used to further improve the FINDRISC for diabetes detection. The new resultant model is especially useful for reclassifying people in the intermediate-risk categories, where additional blood glucose testing is needed to confirm the presence of diabetes.
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Affiliation(s)
- B T Fokkens
- Division of Vascular Medicine, Department of Internal Medicine, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, Netherlands.
| | - R P van Waateringe
- Department of Endocrinology, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - D J Mulder
- Division of Vascular Medicine, Department of Internal Medicine, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - B H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, Netherlands
| | - A J Smit
- Division of Vascular Medicine, Department of Internal Medicine, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, Netherlands
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Glurich I, Nycz G, Acharya A. Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients. Clin Med Res 2017; 15:21-32. [PMID: 28373288 PMCID: PMC5572842 DOI: 10.3121/cmr.2017.1348] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 03/02/2017] [Accepted: 03/24/2017] [Indexed: 02/08/2023]
Abstract
Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oral-systemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously- and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes.
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Affiliation(s)
- Ingrid Glurich
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Gregory Nycz
- Family Health Center of Marshfield, Marshfield Clinic, Marshfield, Wisconsin, USA
| | - Amit Acharya
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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Klein BEK, Horak KL, Maynard JD, Lee KE, Klein R. Association of Skin Intrinsic Fluorescence with Retinal Microvascular Complications of Long Term Type 1 Diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmic Epidemiol 2017; 24:211-216. [PMID: 28287861 DOI: 10.1080/09286586.2016.1269934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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). CONCLUSION Skin intrinsic fluorescence measures are independently associated with PDR in the WESDR. Incidence information is needed to evaluate whether there is a causal relationship.
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Affiliation(s)
- Barbara E K Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Kayla L Horak
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - John D Maynard
- b Medical Device and Diagnostics Consulting , Albuquerque , NM , USA
| | - Kristine E Lee
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Ronald Klein
- a Department of Ophthalmology and Visual Sciences , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
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Fokkens BT, Smit AJ. Skin fluorescence as a clinical tool for non-invasive assessment of advanced glycation and long-term complications of diabetes. Glycoconj J 2016; 33:527-35. [PMID: 27287226 PMCID: PMC4975757 DOI: 10.1007/s10719-016-9683-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 11/29/2022]
Abstract
Glycation is important in the development of complications of diabetes mellitus and may have a central role in the well-described glycaemic memory effect in developing these complications. Skin fluorescence has emerged over the last decade as a non-invasive method for assessing accumulation of advanced glycation endproducts. Skin fluorescence is independently related to micro- and macrovascular complications in both type 1 and type 2 diabetes mellitus and is associated with mortality in type 2 diabetes. The relation between skin fluorescence and cardiovascular disease also extends to other conditions with increased tissue AGE levels, such as renal failure. Besides cardiovascular complications, skin fluorescence has been associated, more recently, with other prevalent conditions in diabetes, such as brain atrophy and depression. Furthermore, skin fluorescence is related to past long-term glycaemic control and clinical markers of cardiovascular disease. This review will discuss the technique of skin fluorescence, its validation as a marker of tissue AGE accumulation, and its use as a clinical tool for the prediction of long-term complications in diabetes mellitus.
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Affiliation(s)
- Bernardina T Fokkens
- Department of Internal Medicine, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. .,Research Institute GUIDE, Graduate School of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - Andries J Smit
- Department of Internal Medicine, University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.,Research Institute GUIDE, Graduate School of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
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Eny KM, Orchard TJ, Miller RG, Maynard J, Grant DM, Costacou T, Cleary PA, Braffett BH, Paterson AD. Caffeine Consumption Contributes to Skin Intrinsic Fluorescence in Type 1 Diabetes. Diabetes Technol Ther 2015; 17:726-34. [PMID: 26192006 PMCID: PMC4575521 DOI: 10.1089/dia.2015.0017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND A variant (rs1495741) in the gene for the N-acetyltransferase 2 (NAT2) protein is associated with skin intrinsic fluorescence (SIF), a noninvasive measure of advanced glycation end products and other fluorophores in the skin. Because NAT2 is involved in caffeine metabolism, we aimed to determine whether caffeine consumption is associated with SIF and whether rs1495741 is associated with SIF independently of caffeine. MATERIALS AND METHODS SIF was measured in 1,181 participants with type 1 diabetes from the Epidemiology of Diabetes Interventions and Complications study. Two measures of SIF were used: SIF1, using a 375-nm excitation light-emitting diode (LED), and SIF14 (456-nm LED). Food frequency questionnaires were used to estimate mean caffeine intake. To establish replication, we examined a second type 1 diabetes cohort. RESULTS Higher caffeine intake was significantly associated with higher SIF1(LED 375 nm[0.6, 0.2]) (P=2×10(-32)) and SIF14L(ED 456 nm[0.4, 0.8]) (P=7×10(-31)) and accounted for 4% of the variance in each after adjusting for covariates. When analyzed together, caffeine intake and rs1495741 both remained highly significantly associated with SIF1(LED 375 nm[0.6, 0.2]) and SIF14(LED 456 nm[0.4, 0.8]). Mean caffeinated coffee intake was also positively associated with SIF1(LED 375 nm[0.6, 0.2]) (P=9×10(-12)) and SIF14(LED 456 nm[0.4, 0.8]) (P=4×10(-12)), but no association was observed for decaffeinated coffee intake. Finally, caffeine was also positively associated with SIF1(LED 375 nm[0.6, 0.2]) and SIF14(LED 456 nm[0.4, 0.8]) (P<0.0001) in the replication cohort. CONCLUSIONS Caffeine contributes to SIF. The effect of rs1495741 on SIF appears to be partially independent of caffeine consumption. Because SIF and coffee intake are each associated with cardiovascular disease, our findings suggest that accounting for coffee and/or caffeine intake may improve risk prediction models for SIF and cardiovascular disease in individuals with diabetes.
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Affiliation(s)
- Karen M. Eny
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Trevor J. Orchard
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rachel Grace Miller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Denis M. Grant
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Tina Costacou
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Patricia A. Cleary
- The Biostatistics Center, The George Washington University, Rockville, Maryland
| | - Barbara H. Braffett
- The Biostatistics Center, The George Washington University, Rockville, Maryland
| | - Andrew D. Paterson
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Azar M, Stoner JA, Dao HD, Stephens L, Goodman JR, Maynard J, Lyons TJ. Epidemiology of Dysglycemia in Pregnant Oklahoma American Indian Women. J Clin Endocrinol Metab 2015; 100:2996-3003. [PMID: 26091203 PMCID: PMC4525008 DOI: 10.1210/jc.2015-1779] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Minority communities are disproportionately affected by diabetes, and minority women are at an increased risk for glucose intolerance (dysglycemia) during pregnancy. OBJECTIVES In pregnant American Indian women, the objectives of the study were to use current criteria to estimate the prevalence of first-trimester (Tr1) dysglycemia and second-trimester (Tr2) incidence of gestational diabetes mellitus (GDM) and to explore new candidate measures and identify associated clinical factors. DESIGN This was a prospective cohort study. In Tr1 we performed a 75-g, 2-hour oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) to determine the following: fasting insulin; homeostasis model assessment of insulin resistance; serum 1,5-anhydroglucitol; noninvasive skin autofluorescence (SCOUT). We defined dysglycemia by American Diabetes Association and Endocrine Society criteria and as HbA1c of 5.7% or greater. In Tr2 in an available subset, we performed a repeat OGTT and SCOUT. PARTICIPANTS Pregnant American Indian women (n = 244 at Tr1; n = 114 at Tr2) participated in the study. OUTCOMES The prevalence of dysglycemia at Tr1 and incidence of GDM at Tr2 were measured. RESULTS At Tr1, one woman had overt diabetes; 36 (15%) had impaired glucose tolerance (American Diabetes Association criteria and/or abnormal HbA1c) and 59 (24%) had GDM-Tr1 (Endocrine Society criteria). Overall, 74 (30%) had some form of dysglycemia. Associated factors were body mass index, hypertension, waist/hip circumferences, SCOUT score, fasting insulin, and homeostasis model assessment of insulin resistance. At Tr2, 114 of the Tr1 cohort underwent a repeat OGTT and SCOUT, and 26 (23%) had GDM. GDM-Tr2 was associated with increased SCOUT scores (P = .029) and Tr1 body mass index, waist/hip circumferences, diastolic blood pressure, fasting insulin, and triglyceride levels. Overall, dysglycemia at Tr1 and/or Tr2 affected 38% of the women. CONCLUSIONS Dysglycemia at some point during pregnancy was common among American Indian women. It was associated with features of insulin resistance and may confer long-term health risks for mother and child.
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Affiliation(s)
- Madona Azar
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - Julie A Stoner
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - Hanh Dung Dao
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - Lancer Stephens
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - Jean R Goodman
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - John Maynard
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
| | - Timothy J Lyons
- Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom
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10
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Pandey R, Dingari NC, Spegazzini N, Dasari RR, Horowitz GL, Barman I. Emerging trends in optical sensing of glycemic markers for diabetes monitoring. Trends Analyt Chem 2015; 64:100-108. [PMID: 25598563 DOI: 10.1016/j.trac.2014.09.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In the past decade, considerable attention has been focused on the measurement of glycemic markers, such as glycated hemoglobin and glycated albumin, that provide retrospective indices of average glucose levels in the bloodstream. While these biomarkers have been regularly used to monitor long-term glucose control in established diabetics, they have also gained traction in diabetic screening. Detection of such glycemic markers is challenging, especially in a point-of-care setting, due to the stringent requirements for sensitivity and robustness. A number of non-separation based measurement strategies were recently proposed, including photonic tools that are well suited to reagent-free marker quantitation. Here, we critically review these methods while focusing on vibrational spectroscopic methods, which offer highly specific molecular fingerprinting capability. We examine the underlying principles and the utility of these approaches as reagentless assays capable of multiplexed detection of glycemic markers and also the challenges in their eventual use in the clinic.
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Affiliation(s)
- Rishikesh Pandey
- Laser Biomedical Research Center, Massachusetts Institute of Technology, Cambridge, Massachusetts, 02139, USA
| | - Narahara Chari Dingari
- Laser Biomedical Research Center, Massachusetts Institute of Technology, Cambridge, Massachusetts, 02139, USA
| | - Nicolas Spegazzini
- Laser Biomedical Research Center, Massachusetts Institute of Technology, Cambridge, Massachusetts, 02139, USA
| | - Ramachandra R Dasari
- Laser Biomedical Research Center, Massachusetts Institute of Technology, Cambridge, Massachusetts, 02139, USA
| | - Gary L Horowitz
- Division of Clinical Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, 02215, USA
| | - Ishan Barman
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA
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11
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Abstract
The development of cost-effective, simple, and reproducible tests for diabetes screening represents a priority of modern medicine in light of the increasing prevalence of diabetes mellitus. Besides fasting plasma glucose, the oral glucose tolerance test, and glycated hemoglobin A1c, several tests have been proposed, among them the assessment of skin fluorescence spectroscopy (SFS). This article comments on the article by Olson and coauthors published in this issue of Journal of Diabetes Science and Technology and comprehensively reviews related available information. Overall, SFS seems to represent an easy-to-use, noninvasive tool that adds value to existing tests for diabetes screening.
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Affiliation(s)
- Alin Stirban
- Profil Institut für Stoffwechselforschung GmbH, Neuss, Germany.
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