Abstract
Background and aimsSkin autofluorescence (AF), a measure of tissue accumulation of advanced glycation end products (AGEs), has been associated with diabetes and cardiovascular disease. However, the association of skin AF with subclinical coronary atherosclerosis in the general population is largely unknown. Our study aimed to examine the associations between skin AF and subclinical atherosclerosis in coronary and carotid arteries in a middle-aged population. MethodsSkin AF and subclinical atherosclerosis were measured in 4416 subjects (aged 50–64 years) from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Skin AF was measured non-invasively using an autofluorescence reader. Subclinical atherosclerosis was assessed by ultrasonography of carotid arteries for evaluation of carotid plaques and computed tomography for the evaluation of the coronary artery calcium score (CACS). ResultsA total of 615 (13.9%) individuals had CACS >100 and 1340 (30.3%) subjects had bilateral carotid plaques (median total plaque area: 8 mm2). After controlling for confounding factors, there were significant associations between skin AF (per 1 standard deviation (SD) increase) and CACS >100: odds ratio (OR) = 1.17, 95% confidence interval (CI): 1.06–1.29, p = 0.001. Total carotid plaque area and occurrence of bilateral carotid plaques (OR per 1 SD increase: 1.10, 95%CI: 1.01–1.19, p = 0.02) were similarly associated with skin AF after multivariable adjustments. ConclusionsElevated skin AF was significantly associated with subclinical atherosclerosis in coronary and carotid arteries independently of conventional risk factors. Skin AF, a measure of accumulation of AGEs, could be a marker for the identification of middle-aged subjects with elevated atherosclerotic risk.
Highlights
Advanced glycation end products (AGEs) are a heterogeneous group of compounds formed by non-enzymatic glycation of proteins, lipids and nucleic acids, endogenously or exogenously
High skin AF was associated with older age, current smoking, Systolic blood pressure (SBP), C-reactive protein (CRP), lipid-lowering, anti-platelet drugs and antihyper tensive medications, prevalent diabetes, high glucose, haemo globin A1c (HbA1c) and body mass index (BMI) (Supplemental Table 1)
We found higher skin AF levels to be significantly associated with coronary calcification and higher carotid total plaque area in this study
Summary
Advanced glycation end products (AGEs) are a heterogeneous group of compounds formed by non-enzymatic glycation of proteins, lipids and nucleic acids, endogenously or exogenously. The accumulation of AGEs can be assessed non-invasively in forearm by skin auto fluorescence (AF), which is a valid measure of tissue fluorescent prop erties [6]. Skin AF as a measure of AGE accumulation was shown to predict CVD [12,13,14] and raised skin AF has been reported in patients with vascular diseases, including coronary artery diseases [15], peripheral artery diseases [16], subclinical atheromatous disease [17] and in elderly individuals with carotid plaque [18]. Skin autofluorescence (AF), a measure of tissue accumulation of advanced glycation end products (AGEs), has been associated with diabetes and cardiovascular disease. Conclusions: Elevated skin AF was significantly associated with subclinical atherosclerosis in coronary and carotid arteries independently of conventional risk factors. Skin AF, a measure of accumulation of AGEs, could be a marker for the identification of middle-aged subjects with elevated atherosclerotic risk
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