Skin autofluorescence is associated with severity of vascular complications in Japanese patients with Type 2 diabetes

Diabet Med. 2012 Apr;29(4):492-500. doi: 10.1111/j.1464-5491.2011.03448.x.

Abstract

Aims: Skin autofluorescence, a non-invasive measure of the accumulation for advanced glycation end products, has been reported to be a useful marker for diabetic vascular risks in the Caucasian population. The aim of this study was to evaluate associations between skin autofluorescence and vascular complications in non-Caucasian patients with Type 2 diabetes.

Methods: Subjects in this cross-sectional study comprised 130 Japanese patients with Type 2 diabetes. Skin advanced glycation end products were assessed by skin autofluorescence using an autofluorescence reader. Association between skin autofluorescence and severity of vascular complications was evaluated.

Results: Of the 130 patients, 60 (46.2%) had microvascular complications such as diabetic retinopathy, neuropathy and nephropathy, 10 (7.7%) had macrovascular complications and 63 (48.5%) had micro- and/or macrovascular complications. Skin autofluorescence increased with severity of vascular complications. Independent determinants of skin autofluorescence were age (β = 0.24, P < 0.01), mean HbA(1c) in previous year (β = 0.17, P = 0.03), microvascular complications (β = 0.44, P < 0.01) and macrovascular complications (β = 0.27, P < 0.01). Multiple logistic regression analysis revealed that diabetes duration (odds ratio 1.15, P < 0.01), systolic blood pressure (odds ratio 1.04, P = 0.01), skin autofluorescence (odds ratio 3.62, P = 0.01) and serum albumin (odds ratio 0.84, P < 0.01) were independent factors for the presence of vascular complications in these patients.

Conclusions: Skin autofluorescence had independent effects on vascular complications in Japanese patients with Type 2 diabetes. This indicates that skin advanced glycation end products are a surrogate marker for vascular risk and a non-invasive autofluorescence reader may be a useful tool to detect high-risk cases in non-Caucasian patients with diabetes.

MeSH terms

  • Aged
  • Asian Continental Ancestry Group
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / metabolism
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / metabolism
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / etiology
  • Diabetic Nephropathies / metabolism
  • Diabetic Neuropathies / epidemiology
  • Diabetic Neuropathies / etiology
  • Diabetic Neuropathies / metabolism
  • Diabetic Retinopathy / epidemiology
  • Diabetic Retinopathy / etiology
  • Diabetic Retinopathy / metabolism
  • Female
  • Fluorescence*
  • Glycated Hemoglobin A / metabolism
  • Glycation End Products, Advanced / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Risk Factors
  • Skin / metabolism*
  • Smoking / adverse effects*

Substances

  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • hemoglobin A1c protein, human