Abstract

Skin auto-fluorescence (SAF) has generated broad interest about the prospects for non-invasive advanced glycation end product assessment and its direct interplay with the development of microvascular complications, but clinical application of the existing SAF measuring of non-palmoplantar sites in non-Caucasian subjects with dark skin type is still controversial. Here, we tested the diabetic complication screening performance of a novel SAF measuring system in Asian type 2 diabetes mellitus (T2DM) subjects. A total of 166 Korean patients with T2DM were enrolled in this study and palmoplantar SAF was measured by a newly developed transmission-geometry noninvasive optical system. We found that transmitted SAF values of palmoplantar sites, 1st dorsal interossei muscles of the hand, in a complication group were significantly higher than in a non-complication group while no differences were observed between the two groups in reflected SAF of non-palmoplantar sites. The transmitted SAF values of palmoplantar sites were dramatically increased in subjects with multiple complications and were tightly correlated with the duration of microvascular complications. In conclusion, the SAF measurement in the palmoplantar sites with a non-invasive transmission-geometry optical system provided better microvascular complication screening performance compared to the SAF measurement of non-palmoplantar sites specifically in Asian T2DM subjects.

Highlights

  • The blood glucose homeostasis is tightly regulated throughout the body and is critically important to ensure sufficient glucose supply for metabolic demands

  • We reported that non-invasive Skin auto-fluorescence (SAF) measurement of the palmoplantar sites, 1st dorsal interossei muscles of the hand with transmission-geometry provided a superior diagnostic performance of abnormal glucose tolerance (AGT) in Korean subjects even compared to blood sample based AGT diagnosis or to SAF reflected from non-palmoplantar sites[15]

  • There were no statistical differences in HbA1c, glycated albumin (GA) and the ratio of GA and HbA1c (GA/HbA1c) between two groups (Fig. 1 and Table 1)

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Summary

ACEIs or ARBs

Subjects without DM complication (n = 56) 59.3 ± 10.7 39 (69.6) 25.5 ± 4.1 89.1 ± 9.7 121.2 ± 12.3 73.9 ± 10.8 8.6 ± 6.4 7.1 ± 1.2 54 ± 13 17.7 ± 5.0 2.3 ± 0.8 127.2 ± 32.0 160.5 ± 34.8 45.5 ± 10.9 132.9 ± 57.1 88.4 ± 29.3 10.5 ± 9.9 88.1 ± 19.1 3.0 ± 1.2 5.1 ± 1.7 26 (46.4) 19 (33.9) 17 (30.4) 12 (21.4) 6 (10.7) 35 (62.5) 29 (51.8) 3 (5.4) 2 (3.6) — — —

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