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

• Published in: Diabetic medicine Vol. 29; no. 4; pp. 492 - 500
• Main Authors: Tanaka, K., Tani, Y., Asai, J., Nemoto, F., Kusano, Y., Suzuki, H., Hayashi, Y., Asahi, K., Nakayama, M., Miyata, T., Watanabe, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-04-2012; Blackwell; Wiley Subscription Services, Inc
• Subjects: advanced glycation end products; Aged; Asian Continental Ancestry Group; Biological and medical sciences; Blood Pressure; Body Mass Index; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - metabolism; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - metabolism; Diabetes. Impaired glucose tolerance; 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; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - etiology; Diabetic Retinopathy - metabolism; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fluorescence; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - metabolism; Glycation End Products, Advanced - metabolism; Humans; Male; Medical sciences; Middle Aged; Reproducibility of Results; Risk Factors; Skin; Skin - metabolism; Smoking - adverse effects; vascular; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; White people; Asia; Japan; Endocrinopathy; Type 2 diabetes; Human; Obesity; Nutrition; Nutrition disorder; Fluorescence; Patient; Metabolic diseases; Severity; Japanese; vascular; Advanced glycation end products; Association; Blood vessel; Complication; Skin; Circulatory system; diabetes; Endocrinology; Nutritional status
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2011.03448.x

Diabet. Med. 29, 492–500 (2012)
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 HbA1c 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.