Abstract
Purpose: :
Skin autofluorescence is a non-invasive measure of the level of advanced glycation end product (AGE) accumulation in tissue. AGEs have been reported to be involved in diabetic microvascular complications. The purpose of this study was to evaluate the association between skin autofluorescence and diabetic retinopathy in Japanese patients with type 2 diabetes.
Methods: :
Sixty-seven diabetic patients (mean age 60.7±9.7 years, male:female=29:38) who visited Tohoku University Hospital and NTT Hospital were included in this cross-sectional study. Patients with Type 1 diabetes, on hemodialysis, with current malignant or inflammatory disease, or chronic respiratory disease were excluded from the study. The subjects were classified into three groups according to the stage of diabetic retinopathy (DR): no DR (NDR; 15 cases), non-proliferative DR (NPDR; 31 cases), and proliferative DR (PDR; 21 cases). Skin autofluorescence was measured using the AGE Reader (DiagnOptics BV, Groningen, The Netherlands). The Kruskal-Wallis test with post-hoc Steel-Dwass test was applied to compare the differences between groups. Spearman’s rank correlation test was used to estimate the relationships between variables.
Results: :
The median of skin autofluorescence increased with the severity of DR (NDR; 2.2, NPDR; 2.5, PDR; 2.8). The median of skin autofluorescence in PDR was significantly higher than in the other two groups (PDR vs NDR; p=0.0003, PDR vs NPDR; p=0.0026). In addition, the median of skin autofluorescence in NPDR was significantly higher than in NDR (p=0.0336). Skin autofluorescence was significantly correlated to the severity of diabetic retinopathy (r=0.56, p<0.001).
Conclusions: :
Skin autofluorescence is associated with the stages of diabetic retinopathy. Non-invasive AGE measurement may be a useful tool to evaluate the risk of diabetic retinopathy.
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: risk factor assessment • diabetes