Skin Autofluorescence is Associated with Early-stage Atherosclerosis in Patients with Type 1 Diabetes

Aim: Accumulation level of fluorescent advanced glycation end products (AGEs) in the skin can be measured non-invasively as skin autofluorescence (skin AF) by autofluorescence reader. The aim of this study was to assess possible associations between skin AF and diabetic complications, especially early-stage atherosclerosis, in Japanese type 1 diabetic patients. Methods: Skin AF was measured by AGE reader((R)) in 105 Japanese type 1 diabetic patients (34 men and 71 women, aged 37.4 +/- 12.4 years (+/- SD)) and 23 age-matched healthy non-diabetic subjects. Ultrasonic carotid intima-media thickness (IMT), ankle-brachial index (ABI), and brachial ankle pulse wave velocity (baPWV) were evaluated as indices of early-stage diabetic macroangiopathy. Urinary albumin-to-creatinine ratio (UACR), the coefficient of variation of R-R intervals (CVR-R), and presence of retinopathy were also evaluated. Results: Skin AF values were significantly higher in type 1 diabetic patients than in healthy controls (2.07 +/- 0.50 (mean +/- SD) and 1.90 +/- 0.26, respectively, p= 0.024). Skin AF was associated with carotid IMT (r = 0.446, p< 0.001) and baPWV (r = 0.450, p< 0.001), but not with ABI (r = -0.019, p= 0.8488). Notably, skin AF was an independent risk factor for IMT thickening. Similarly, skin AF was associated with log (UACR) (r = 0.194, p= 0.049) and was an independent risk factor for UACR. Furthermore, skin AF values were significantly higher in patients with diabetic retinopathy than in those without (2.21 +/- 0.08 and 1.97 +/- 0.06, respectively, p= 0.020). Conclusions: Skin AF was significantly associated with the presence and/or severity of diabetic complications and was an independent risk factor for carotid atherosclerosis.