Advanced glycation endproducts in children with diabetes.

OBJECTIVES: To estimate skin content of advanced glycation endproducts (AGEs) by measurements of skin intrinsic fluorescence (SIF) from youth with diabetes in comparison with a population of youth and adults without diabetes. STUDY DESIGN: Using a specialized instrument, skin AGEs were estimated from skin auto-fluorescence induced at 420 nm and corrected for skin pigmentation (SIF420[kx0.5, km0.5]) in children with types 1 and 2 diabetes, as well as children and adults without diabetes. The effect of age, sex, ethnicity, and diabetes status on SIF420[kx0.5, km0.5] was analyzed. RESULTS: SIF420[kx0.5, km0.5] increased with chronologic age and was higher in children with diabetes compared with children without diabetes (P = .0001). SIF420[kx0.5, km0.5] from 43% of children with type 1 diabetes and 55% with type 2 diabetes overlapped the range of adults without diabetes. SIF420[kx0.5, km0.5] was higher in girls than boys in patients with diabetes patients. However, there was no effect of sex or race on SIF420[kx0.5, km0.5] in subjects without diabetes. CONCLUSIONS: After 4-6 years' exposure to diabetes, many children will have precociously high estimates of skin AGEs, comparable with levels that would naturally accumulate only after ∼25 years of chronologic aging. Potentially, this technology identifies children who are at increased risk for complications.

Correlation of advanced glycation endproducts estimated from skin fluorescence in first-degree relatives: the impact of adjustment for skin pigmentation.

The objective was to assess the relationship of skin advanced glycation endproducts (AGEs) between first-degree relatives estimated from skin fluorescence (SF) after adjustment for skin pigmentation. SF was excited by LEDs centered at 375, 405, and 420 nm from children with type 1 diabetes and their mothers. Data were adjusted to generate measures of skin intrinsic fluorescence (SIF) at the various excitation wavelengths, using 2 different pairs of correction coefficients for excitation (kx) and emission (km): kx = 0.5, km = 0.5 (not associated with skin pigmentation) and kx = 1.0, km = 0.0 (strongly associated with skin pigmentation). Pearson correlation analysis was performed, as well as a multiple variable analysis with maternal SIF adjusted for the effects of maternal age and race. There were 50 matched pairs of children and their mothers. Children were 13.3 ± 3.7 years of age and there were 19 boys/31 girls and 15 black/35 white. Mothers were 41.8 ± 6.8 years of age. The age of mother and child was highly correlated, r = .64, P < .0001. In Pearson correlation analysis, child's SIF (kx = 1.0, km = 0.0) the had strongest association with maternal SIF, while with SIF (kx = 0.5, km = 0.5) there was a trend for association. In the multiple variable model child SIF was associated with maternal SIF for all corrections and wavelengths but was stronger for kx = 1.0, km = 0.0. Even after adjustment for skin pigmentation and race, correlation of SIF between family members persists, suggesting that other genetic and/or environmental factors shared by parent and child may influence estimated skin AGEs.

Skin advanced glycation endproducts are elevated at onset of type 1 diabetes in youth.

OBJECTIVES: To compare skin advanced glycation endproducts (AGEs) in children at onset of type 1 diabetes with children without diabetes. STUDY DESIGN: Skin AGEs (sAGEs) were estimated by measurement of skin intrinsic fluorescence (SIF) at diagnosis of type 1 diabetes (NewD; n=47, F=45%, M=55%, Age=10±3.7) and in youth without diabetes (NoD; n=112, F=53%, M=47%, Age=10.4±4.8). HCO3, pH, pCO2, glucose level, and HbA1c effect on SIF was evaluated in NewD patients. RESULTS: SIF at 405 nm and 420 nm excitation were higher (p=0.03) in NewD children compared to NoD. HCO3, pH, pCO2, glucose, and HbA1c were not associated with SIF levels. CONCLUSIONS: Despite the short duration of untreated diabetes, sAGEs were higher in children with NewD compared to children with NoD. Further study will be needed to determine whether early accumulation of sAGEs is associated with higher risk for development and progression of complications.