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Jujic A, Engström G, Nilsson PM, Johansson M. Accumulation of advanced glycation end products in skin and increased vascular ageing in the general population: the Malmö Offspring Study. J Hypertens 2024; 42:530-537. [PMID: 38088420 PMCID: PMC10842672 DOI: 10.1097/hjh.0000000000003627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/16/2023] [Accepted: 11/07/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVES Advanced glycation end product (AGE) is an established risk marker for diabetic vascular disease, and associated with the degree of diabetes complications, renal failure, and atherosclerosis in middle-aged and older individuals. The relationship between AGEs and aortic stiffness has not been thoroughly examined in the younger general population. We aimed to evaluate the association between AGEs and aortic stiffness in the general population of young and middle-aged adults. METHODS We analysed cross-sectionally 2518 participants from a Swedish population-based cohort, the Malmö Offspring Study (mean age 41.8 ± 14.5 years, 52.2%). Advanced glycation end-products (AGEs) were measured by a well validated, noninvasive method using skin autofluorescence with AGE-Reader. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (PWV) and augmentation index (Aix) was calibrated to a standard heart rate of 75 bpm at the arteria radialis using SphygmoCor. Multivariable linear regression was performed stratified by age to analyse the association between skin AGE and aortic stiffness. RESULTS Increased levels of AGEs were significantly associated with higher direct measurements of aortic stiffness (vascular ageing) in younger individuals (PWV β 0.55 m/s, P < 0.001) after adjustment for traditional cardiometabolic risk factors, however, not in older individuals (PWV β 0.23 m/s, P = 0.10). Indirect vascular ageing was also significantly associated with higher levels of AGEs in both younger (Aix β 7.78, P < 0.001) and older individuals (Aix β 3.69, P < 0.001). CONCLUSION Higher levels of skin autofluorescence-AGEs are positively associated with increased vascular ageing in younger adults from the general population, independent of cardiometabolic risk factors.
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Affiliation(s)
- Amra Jujic
- Department of Clinical Sciences, Lund University
- Department of Cardiology, Skåne University Hospital
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | | | | | - Madeleine Johansson
- Department of Clinical Sciences, Lund University
- Department of Cardiology, Skåne University Hospital
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Chen J, Arshi B, Waqas K, Lu T, Bos D, Ikram MA, Uitterlinden AG, Kavousi M, Zillikens MC. Advanced glycation end products measured by skin autofluorescence and subclinical cardiovascular disease: the Rotterdam Study. Cardiovasc Diabetol 2023; 22:326. [PMID: 38017418 PMCID: PMC10685533 DOI: 10.1186/s12933-023-02052-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/03/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Advanced glycation end products (AGEs) have been linked to cardiovascular disease (CVD), especially coronary heart disease (CHD), but their role in CVD pathogenesis remains unclear. Therefore, we investigated cross-sectional associations of skin AGEs with subclinical atherosclerosis, arterial stiffness, and hypertension after confirming their relation with CHD. METHODS In the population-based Rotterdam Study, skin AGEs were measured as skin autofluorescence (SAF). Prevalent MI was obtained from digital medical records. Carotid plaques, carotid intima-media thickness (IMT), coronary artery calcification (CAC), pulse wave velocity (PWV), and hypertension were assessed. Associations of SAF with endophenotypes were investigated in logistic and linear regression models adjusting for common cardiovascular risk factors. Effect modification by sex, diabetes mellitus, and chronic kidney disease (CKD) was tested. RESULTS 3001 participants were included (mean age 73 (SD 9) years, 57% women). One unit higher SAF was associated with the presence of carotid plaques (OR 1.2 (0.92, 1.57)), a higher max IMT (0.08 SD (0.01, 0.15)), higher CAC (OR 2.2 (1.39, 3.48)), and PWV (0.09 SD (0.01, 0.16)), but not with hypertension (OR 0.99 (0.81, 1.21)). The associations with endophenotypes were more pronounced in men and participants with diabetes or CKD with significant interactions. CONCLUSIONS Previously documented associations between SAF and CVD, also found in our study, may be explained by the endophenotypes atherosclerosis and arterial stiffness, especially in men and individuals with diabetes or CKD, but not by hypertension. Longitudinal studies are needed to replicate these findings and to test if SAF is an independent risk factor or biomarker of CVD. TRIAL REGISTRATION The Rotterdam Study has been entered into the Netherlands National Trial Register (NTR; www.trialregister.nl ) and the WHO International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/network/primary/en/ ) under shared catalogue number NTR6831.
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Affiliation(s)
- Jinluan Chen
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Banafsheh Arshi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Komal Waqas
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
| | - Tianqi Lu
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands.
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Hirai T, Fujiyoshi K, Yamada S, Matsumoto T, Kikuchi J, Ishida K, Ishida M, Shigeta K, Tojo T. Association between fingertip-measured advanced glycation end products and cardiovascular events in outpatients with cardiovascular disease. Cardiovasc Diabetol 2023; 22:213. [PMID: 37592261 PMCID: PMC10436644 DOI: 10.1186/s12933-023-01953-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The accumulation of advanced glycation end products (AGEs) is associated with cardiovascular events in patients with cardiovascular disease (CVD). However, the relationship between the AGEs measured by an AGEs sensor noninvasively at the fingertip and prognosis in patients with CVD remains unclear. Therefore, this study aimed to determine the relationship between AGEs score and prognosis among patients with CVD. METHODS A total of 191 outpatients with CVD were included. AGEs score were measured using an AGEs sensor and the patients were classified into groups by the median value of AGEs score. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) at 30 months was compared between high- and low-AGEs score groups. In addition, receiver operating characteristic (ROC) curve analysis was used to calculate cutoff value for the AGEs score, which discriminates the occurrence of MACCE. Cox regression analysis was performed to identify the factors associated with the presence of MACCE. MACCE included cardiac death, myocardial infarction, percutaneous coronary intervention, heart failure, and stroke. RESULTS AGEs score was normally distributed, with a median value of 0.51. No significant intergroup differences were found in laboratory findings, physical functions, or medications. The high-AGEs score group had a significantly higher incidence of MACCE than the low-AGEs score group (27.1 vs. 10.5%, P = 0.007). A high-AGEs score was a risk factor for MACCE (hazard ratio, 2.638; 95% confidence interval, 1.271-5.471; P = 0.009). After the adjustment for confounders other than 6-min walking distance, the AGEs score remained a factor associated with the occurrence of MACCE. The best cutoff AGEs score for the detection of MACCE was 0.51 (area under the curve, 0.642; P = 0.008; sensitivity, 72.2%; specificity, 54.8%). CONCLUSIONS AGEs score measured at the fingertip in patients with CVD is associated with MACCE. AGEs score, which can be measured noninvasively and easily, may be useful as an assessment for the secondary prevention of CVD in patients with CVD.
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Affiliation(s)
- Tomoya Hirai
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
- Department of Cardiac Rehabilitation, Kitasato University Kitasato Institute Hospital, Minato-Ku, Japan
| | - Kazuhiro Fujiyoshi
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan.
| | - Satoru Yamada
- Diabetes Center, Kitasato University Kitasato Institute Hospital, Minato-ku, Japan
| | - Takuya Matsumoto
- Department of Cardiac Rehabilitation, Kitasato University Kitasato Institute Hospital, Minato-Ku, Japan
| | - Junko Kikuchi
- Department of Cardiac Rehabilitation, Kitasato University Kitasato Institute Hospital, Minato-Ku, Japan
| | - Kohki Ishida
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital, Minato-ku, Japan
| | - Miwa Ishida
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital, Minato-ku, Japan
| | - Kyo Shigeta
- Department of Cardiac Rehabilitation, Kitasato University Kitasato Institute Hospital, Minato-Ku, Japan
| | - Taiki Tojo
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital, Minato-ku, Japan
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Aoki E, Hirashima T, Kumamoto Y, Yamamoto Y, Suzuki N, Oshima T, Saito D, Hirano T. Clinical significance of skin autofluorescence for diabetic macroangiopathy and comparison with conventional markers of atherosclerosis: a cross-sectional and prospective study. Diabetol Int 2023; 14:145-154. [PMID: 37090128 PMCID: PMC10113414 DOI: 10.1007/s13340-022-00608-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
Background Skin autofluorescence (SAF) is a marker for the accumulation of advanced glycation end products (AGEs), and is associated with diabetic macroangiopathy. However, whether SAF is superior to conventional markers of atherosclerosis such as carotid intima-media thickness (IMT) and pulse wave velocity (PWV) in detecting macroangiopathy remains unclear. Methods We recruited 845 patients with type 2 diabetes enrolled in a community diabetes cohort (ViNA cohort) who had SAF, IMT, and PWV measured at baseline. The prevalence of macroangiopathy at baseline and new cardiovascular events during the 2-year follow-up period was investigated. SAF was measured using an AGE reader. Coronary artery calcification (CAC) was measured by computed tomography in 485 patients. Peripheral artery disease (PAD) was defined as the ankle-brachial blood pressure ratio of ≤ 0.9. Results SAF, IMT, and PWV were significantly correlated with each other, and age, diabetes duration, and estimated glomerular filtration rate were their strong confounders. SAF was associated with baseline stroke and new stroke after adjusting for confounders, but not with coronary artery disease (CAD) or PAD. The nonsignificant relationship between SAF and CAD was consistent with the relationship between SAF and CAC. Multivariate analysis showed a significant association of SAF with baseline and new stroke independent of IMT and PWV. Maximum-IMT was significantly associated with baseline CAD, PAD, and stroke, but not with a new stroke, whereas PWV was associated with a new stroke. Conclusion Among diabetic macroangiopathies, SAF is a good stroke biomarker, but not for CAD and PAD. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-022-00608-8.
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Affiliation(s)
- Ema Aoki
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Takeshi Hirashima
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Yuko Kumamoto
- Department of Clinical Laboratory, Ebina General Hospital, Ebina, Japan
| | - Yuko Yamamoto
- Department of Clinical Laboratory, Ebina General Hospital, Ebina, Japan
| | - Natsuko Suzuki
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Taito Oshima
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
| | - Daizo Saito
- Department of Nutrition, Ebina General Hospital, Ebina, Japan
| | - Tsutomu Hirano
- Diabetes Center, Ebina General Hospital, Kawaharaguchi 1320, Ebina, Kanagawa 243-0433 Japan
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Fujiwara R, Anzai N, Ishikawa M, Takahashi A. Usefulness of Skin Autofluorescence as a Biomarker of Acute Oxidative Stress in Young Male Japanese Long-Distance Runners: A Cross-Sectional Study. Sports (Basel) 2022; 10:sports10110180. [PMID: 36422949 PMCID: PMC9699520 DOI: 10.3390/sports10110180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
Chronic oxidative stress in long-distance runners adversely affects conditioning. It is important to objectively assess and monitor oxidative stress, but measuring oxidative stress can be invasive or require skill to measure. Therefore, this study aimed to verify whether skin autofluorescence (SAF), a non-invasive, rapid, and easily calculable metric for calculating advanced glycation end products (AGEs), is useful as an oxidative stress biomarker. The subjects were 50 young Japanese male long-distance runners (aged 20.2 ± 1.2 years); 35 average-sized male university students (aged 19.8 ± 1.1 years) served as controls. The interactions and relationships between SAF and plasma pentosidine and oxidative stress markers (reactive oxygen metabolite-derived compounds [d-ROMs], biological antioxidant potential [BAP], and the BAP/d-ROMs ratio) in runners were examined, and SAF in the runners and controls was compared. The results suggest that plasma pentosidine in runners is associated with oxidative stress markers and that it can assess oxidative stress. However, as SAF was not associated with oxidative stress markers, it was not validated as one. In future, clarifying the factors affecting SAF may also clarify the relationship between SAF, plasma pentosidine, and oxidative stress markers.
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Affiliation(s)
- Rei Fujiwara
- Department of Food and Nutrition, Junior College, Nihon University, 2-31-145 Bunkyo-Cho, Mishima 411-8555, Shizuoka, Japan
| | - Natsume Anzai
- Department of Philosophy, Division of Humanities, Graduate School of Humanities, Osaka University, 1-5 Machikaneyama-Cho, Toyonaka 560-8532, Osaka, Japan
| | - Motoyasu Ishikawa
- Department of Food and Nutrition, Junior College, Nihon University, 2-31-145 Bunkyo-Cho, Mishima 411-8555, Shizuoka, Japan
| | - Atsuhiko Takahashi
- Department of Food and Nutrition, Junior College, Nihon University, 2-31-145 Bunkyo-Cho, Mishima 411-8555, Shizuoka, Japan
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Chen Q, Kou M, He Y, Zhao Y, Chen L. Constructing hierarchical surface structure of hemodialysis membranes to intervene in oxidative stress through Michael addition reaction between tannic acid and PEtOx brushes. J Memb Sci 2022. [DOI: 10.1016/j.memsci.2022.120700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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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.
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Skin accumulation of advanced glycation end products and cardiovascular risk in Korean patients with type 2 diabetes mellitus. Heliyon 2022; 8:e09571. [PMID: 35711980 PMCID: PMC9192809 DOI: 10.1016/j.heliyon.2022.e09571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/01/2022] [Accepted: 05/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background The formation of advanced glycation end products (AGEs) takes place during normal aging; however, their production is faster in people having diabetes. The accumulated AGEs reportedly play a role in the occurrence of various age-related disorders. Furthermore, the skin autofluorescence (SAF) technique can be used to detect accumulated AGEs levels. There are few reports on the association between skin accumulation of AGEs and risk of complications in type 2 diabetes mellitus. Methods In this study, we aimed to describe the association between the skin accumulation of AGEs and cardiovascular risk factors in Korean patients with type 2 diabetes. A total of 310 Korean patients with diabetes were enrolled, and the levels of AGEs were measured using SAP. Levels of fasting blood glucose (FBS), triglycerides, total cholesterol, low- and high-density lipoprotein cholesterol, proteinuria, arterial pulse wave velocity (PWV), and blood vessel age were measured using an automatic waveform analyzer. General linear models were used to identify the independent effect of AGEs after adjusting for covariates (age, weight, and duration of diabetes). Results The skin levels of AGEs were strongly correlated with the diabetes duration. Significant independent associations were observed for AGEs with FBS (P < 0.01), proteinuria (P < 0.001), and PWV (P < 0.001). The advanced glycated product was independently associated to the arterial pulse wave conduction velocity that is used as a representative method for measuring arteriosclerosis by analysis early cardiovascular risk factors. Conclusion Our results show that an increase in SAF levels in Korean patients with type 2 diabetes is associated with PWV and vein age, and thereby with arterial stiffness. Therefore, our results suggest that AGEs are associated with cardiovascular risk factors. The level of AGEs can thus be used as an indicator of cardiovascular diseases in the clinical diagnosis of patients with type 2 diabetes. Unclear association between skin accumulation of AGEs and T2DM complication risk. Study Population: Korean patients with T2DM. Strong correlation between skin levels of AGEs and diabetes duration. Independent association between AGEs and arterial pulse wave conduction velocity. Association between increased SAF levels in with PWV, vein age, arterial stiffness.
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Di Raimondo D, Musiari G, Rizzo G, Pirera E, Signorelli SS. New Insights in Prevention and Treatment of Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042475. [PMID: 35206661 PMCID: PMC8872199 DOI: 10.3390/ijerph19042475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Domenico Di Raimondo
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
- Correspondence: ; Tel.: +39-091-6552180
| | - Gaia Musiari
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
| | - Giuliana Rizzo
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
| | - Edoardo Pirera
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
| | - Salvatore Santo Signorelli
- Medical Angiology Unit, Department of Clinic and Experimental Medicine, University of Catania, 95124 Catania, Italy;
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Hosseini MS, Razavi Z, Ehsani AH, Firooz A, Afazeli S. Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis. EClinicalMedicine 2021; 42:101194. [PMID: 34841236 PMCID: PMC8605318 DOI: 10.1016/j.eclinm.2021.101194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Advanced glycation end products (AGE), one of the main factors causing diabetic end-organ damage, accumulate in long half-life proteins, such as skin and cartilage collagen. AGE measurement may offer additional evidence to predict diabetic vascular complications. Skin autofluorescence (SAF) is suggested as a non-invasive, quick, and reliable method to measure tissue AGE level. The aim of this study was to review and evaluate evidence on the clinical validation of SAF measurement in diabetes mellitus (DM) patients. METHODS In this systematic review and meta-analysis, we searched "PubMed" (MEDLINE) and "Cochrane" databases from their inception to 10 August 2021 for observational studies concerning SAF measurement in diabetic patients. The following key terms were used in advanced searching: "Diabetes", "Diabetes Mellitus"," DM", "Glycation ", "Advanced Glycation End product", "AGE", "skin autofluorescence", "SAF". Published studies that included DM patients and estimated their AGE using SAF were considered eligible for meta-analysis. Articles that were editorials, study proposals, congress posters, or case reports and were not on human subjects were excluded. We used a random-effect models for meta-analyzing the clinical validation of SAF in DM with particular emphasis on chronic diabetes complications. FINDINGS We identified 881 records and twenty-nine records fulfilled our eligibility criteria and were included in the systematic review and meta-analysis. A statistically significant correlation was found between SAF and diabetes last HbA1c 0.21(0.13,0.28) in studies with substantial heterogeneity (I2=77.99%, p<0.05). Nevertheless, a significant positive association between SAF level and diabetic retinopathy (DR) [(OR= 1.05, 95% CI=1.03,1.08), (I2=63.78%, p<0.05)], diabetic peripheral neuropathy (DPN) [(OR= 1.11, 95%CI= 1.06,1.16), (I2=79.17%, p<0.05)], diabetic nephropathy (DNP) [(OR= 1.08, 95%CI: 1.05,1.11), (I 2 =65.36%, p<0.05)] and diabetic macrovascular events (D-MVE) [(OR=1.08, 95%CI=1.05,1.11) (I2=67.32, p<0.05)] were found. INTERPRETATION Our study confirmed the significance of SAF measurement as a non-invasive surrogate marker of DM micro and macrovascular complications. Skin AGE estimation may be a useful factor for the prediction and early detection of irreversible DM complications. More studies with larger populations and longer follow-up periods are required.
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Affiliation(s)
- Mahboobeh sadat Hosseini
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Science, Tehran, Iran
| | - Zahra Razavi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Amir Houshang Ehsani
- Department of Dermatology, Razi Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Alireza Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Science, Tehran, Iran
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Krasnodębski M, Grąt K, Morawski M, Borkowski J, Krawczyk P, Zhylko A, Skalski M, Kalinowski P, Zieniewicz K, Grąt M. Skin autofluorescence as a novel predictor of acute kidney injury after liver resection. World J Surg Oncol 2021; 19:276. [PMID: 34526025 PMCID: PMC8444415 DOI: 10.1186/s12957-021-02394-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
Abstract Background Skin autofluorescence (SAF) reflects accumulation of advanced glycation end-products (AGEs). The aim of this study was to evaluate predictive usefulness of SAF measurement in prediction of acute kidney injury (AKI) after liver resection. Methods This prospective observational study included 130 patients undergoing liver resection. The primary outcome measure was AKI. SAF was measured preoperatively and expressed in arbitrary units (AU). Results AKI was observed in 32 of 130 patients (24.6%). SAF independently predicted AKI (p = 0.047), along with extent of resection (p = 0.019) and operative time (p = 0.046). Optimal cut-off for SAF in prediction of AKI was 2.7 AU (area under the curve [AUC] 0.611), with AKI rates of 38.7% and 20.2% in patients with high and low SAF, respectively (p = 0.037). Score based on 3 independent predictors (SAF, extent of resection, and operative time) well stratified the risk of AKI (AUC 0.756), with positive and negative predictive values of 59.3% and 84.0%, respectively. In particular, SAF predicted AKI in patients undergoing major and prolonged resections (p = 0.010, AUC 0.733) with positive and negative predictive values of 81.8%, and 62.5%, respectively. Conclusions AGEs accumulation negatively affects renal function in patients undergoing liver resection. SAF measurement may be used to predict AKI after liver resection, particularly in high-risk patients.
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Affiliation(s)
- Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
| | - Karolina Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Morawski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Borkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Andriy Zhylko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Skalski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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Indyk D, Bronowicka-Szydełko A, Gamian A, Kuzan A. Advanced glycation end products and their receptors in serum of patients with type 2 diabetes. Sci Rep 2021; 11:13264. [PMID: 34168187 PMCID: PMC8225908 DOI: 10.1038/s41598-021-92630-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023] Open
Abstract
Glycation is a non-enzymatic process involving the reaction of reducing sugars or reactive oxoaldehyde with proteins, lipids or nucleic acids, which results in the formation of advanced glycation end products (AGEs). The presented work discusses the glycation process in people with advanced stage of type 1 or type 2 diabetes. The concentration of different AGEs and their receptors for 58 serum samples was determined by ELISA and by spectrofluorimetric methods. In addition to fluorescent low molecular weight and protein-bound AGEs, we have also marked a new class of AGEs: melibiose-derived glycation product (MAGE). Our attention was also focused on the two groups of AGEs receptors: scavenger receptors (SR-A and SR-B) and RAGE. The correlation between the SR-AI scavenging receptors concentration and the fluorescence of AGEs as well as diabetes biological markers: GFR, creatinine contentration and HbA1c was demonstrated. A relationship between the concentration of AGEs and their receptors was also found in serum sample of patients treated with the metformin and aspirin. Furthermore, the concentration of SR-AI scavenger and the fluorescence of total AGEs was significantly lower in treated patients than in non treated patients. AGEs have also been found to contribute to the development of cardiovascular disease, atherosclerosis and diabetic complications, what could be deduced from the correlation of AGEs level and HDL cholesterol or uric acid level. Thus, it was confirmed that AGEs are involved in the pathomechanism of diabetes and other degenerative diseases. Nowadays, it is believed that AGEs due to the long time remaining in the body may be an important diagnostic marker. Their determination may allow monitoring the progression of the disease and the effectiveness of the therapy.
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Affiliation(s)
- Diana Indyk
- grid.4495.c0000 0001 1090 049XDepartment of Medical Biochemistry, Wroclaw Medical University, T. Chałubińskiego 10, 50-368 Wrocław, Poland
| | - Agnieszka Bronowicka-Szydełko
- grid.4495.c0000 0001 1090 049XDepartment of Medical Biochemistry, Wroclaw Medical University, T. Chałubińskiego 10, 50-368 Wrocław, Poland
| | - Andrzej Gamian
- grid.413454.30000 0001 1958 0162Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114 Wrocław, Poland
| | - Aleksandra Kuzan
- grid.4495.c0000 0001 1090 049XDepartment of Medical Biochemistry, Wroclaw Medical University, T. Chałubińskiego 10, 50-368 Wrocław, Poland
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