Abstract
BackgroundWe aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascular events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D).MethodsTwo hundred and forty-three patients (51.2 ± 16.7 years old) with T1D participated. SAF was measured by AGE-Reader-TM at inclusion. Macrovascular events (MVE), estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (AER) were recorded then and 4 years later. Multivariate logistic regression was used to analyze the relationships between SAF and incident MVE and renal profile 4 years later.ResultsPatients with incident MVE had a higher SAF (p = 0.003). SAF predicted incident MVE after adjustment for age, sex, body mass index, tobacco, diabetes duration, hypertension, HbA1c, AER, eGFR (OR 4.84 [95 % CI 1.31–17.89], p = 0.018). However, this relation was no longer significant after adjustment for history of MVE. An inverse relation was found between SAF and incident eGFR (p = 0.0001). Patients with incident eGFR <60 ml/min/1.73 m2 had a SAF higher than patients with normal eGFR. After adjustment for the previous criteria, SAF remained associated with the risk of impaired incident eGFR (OR 7.42 [95 % CI 1.59–34.65], p = 0.018). No relation was found between SAF and increased AER 4 years later.ConclusionsSAF predicts MVE in patients with T1D, adjusted for cardiovascular risk factors but the most powerful predictive factor remains history of MVE. SAF also predicts eGFR impairment, adjusted for initial AER and renal function. SAF could be a useful non-invasive tool for estimating risk of cardiovascular or renal impairment in patients with T1D.
Highlights
We aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascu‐ lar events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D)
Mean SAF value was 2.13 ± 0.58 arbitrary units (AU) at baseline related to age, gender, duration of diabetes and estimated glomerular filtration rate (eGFR)
This difference persisted after adjustment for sex, age, body mass index (BMI), tobacco, diabetes duration, arterial hypertension and HbA1c (B = 0.26 [0.03–0.50], p = 0.027), but not after adjustment for albumin excretion rate (AER) and eGFR (B = 0.17 [−0.06 to 0.40], p = 0.149)
Summary
We aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascu‐ lar events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D). Further oxidation and dehydration give rise to numerous AGEs. Further oxidation and dehydration give rise to numerous AGEs They can be exogenously ingested from food, or endogenously produced in situations of hyperglycaemia and oxidative stress [3]. In this context, AGEs are suspected to play an important role in this cardio-renal risk, as they. Vélayoudom‐Céphise et al Cardiovasc Diabetol (2016) 15:127 promote inflammation and endothelial dysfunction [4] Their accumulation is increased in CKD, due to reduced clearance of their precursors [5]. The complex time consuming analysis of AGEs, and the invasiveness of skin biopsies preclude the use of AGEs for prognosis in a normal clinical routine
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