Higher skin autofluorescence in young people with Type 1 diabetes and microvascular complications. Issue 4 (18th November 2016)

• Record Type: Journal Article
• Authors: Cho, Y. H.; Craig, M. E.; Januszewski, A. S.; Benitez‐Aguirre, P.; Hing, S.; Jenkins, A. J.; Donaghue, K. C.
• Is Part Of: Diabetic medicine. Volume 34:Issue 4(2017)
• Page Start: 543
• Page End: 550
• Publication Date: 2016-11-18
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13280
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aim: To test the hypothesis that non‐invasive skin autofluorescence, a measure of advanced glycation end products, would provide a surrogate measure of long‐term glycaemia and be associated with early markers of microvascular complications in adolescents with Type 1 diabetes. Methods: Forearm skin autofluorescence (arbitrary units) was measured in a cross‐sectional study of 135 adolescents with Type 1 diabetes [mean ±sd age 15.6 ± 2.1 years, diabetes duration 8.7 ± 3.5 years, HbA1c 72 ± 16 mmol/mol (8.7 ± 1.5%)]. Retinopathy, assessed using seven‐field stereoscopic fundal photography, was defined as ≥1 microaneurysm or haemorrhage. Cardiac autonomic function was measured by standard deviation of consecutive RR intervals on a 10‐min continuous electrocardiogram recording, as a measure of heart rate variability. Results: Skin autofluorescence was significantly associated with age ( R 2 = 0.15; P < 0.001). Age‐ and gender‐adjusted skin autofluorescence was associated with concurrent HbA1c ( R 2 = 0.32; P < 0.001) and HbA1c over the previous 2.5–10 years ( R 2 = 0.34–0.43; P < 0.002). Age‐ and gender‐adjusted mean skin autofluorescence was higher in adolescents with retinopathy vs those without retinopathy [mean 1.38 (95% CI 1.29, 1.48) vs 1.22 (95% CI 1.17, 1.26) arbitrary units; P = 0.002]. In multivariable analysis, retinopathy was significantly associated with skin autofluorescence, adjusted for duration ( R 2 = 0.19; P = 0.03). Cardiac autonomic dysfunction was also independently associated with skin autofluorescence ( R 2 = 0.11; P = 0.006). Conclusions: Higher skin autofluorescence is associated with retinopathy and cardiac autonomic dysfunction in adolescents with Type 1 diabetes. The relationship between skin autofluorescence and previous glycaemia may provide insight into metabolic memory. Longitudinal studies will determine the utility of skin autofluorescence as a non‐invasive screening tool to predict future microvascular complications. What's new?: Higher skin autofluorescence (a non‐invasive measure of advanced glycation end products) is significantly associated with early retinopathy and abnormal cardiac autonomic function in adolescents with Type 1 diabetes. Skin autofluorescence reflects up to 10 years of glycaemic history in adolescents with Type 1 diabetes, and may provide a measure of 'metabolic memory'.