Assessment of skin autofluorescence as a marker of advanced glycation end product accumulation in type 1 diabetes.

INTRODUCTION: Advanced glycation end products (AGEs) are important in the pathogenesis of atherosclerosis and reflect the risk of cardiovascular mortality. AGE levels are significantly higher in patients with diabetes. OBJECTIVES: The aim of the study was to compare AGE accumulation in the skin of patients with type 1 diabetes and nondiabetic population as well as to assess its association with disease duration and metabolic control. We also aimed to assess the potential usefulness of this method in the monitoring of diabetes control, especially in a long-term follow-up. PATIENTS AND METHODS: The study included 140 type 1 diabetes patients (mean age 30.4 ± 9.7 years; mean disease duration 13.6 ± 8.5 years) and 57 nondiabetic subjects. AGE accumulation in the skin was assessed noninvasively with the AGE Reader device, which measures autofluorescence (AF) that occurs because some AGEs have fluorescent properties. RESULTS: Mean AF in the diabetes group was 2.13 ± 0.55 and it was significantly higher than in controls (AF 1.70 ± 0.27, P <0.05). A significant positive correlation between AF and the age of patients was found for the whole study population (P <0.05). In diabetic subjects, we observed a significant positive correlation between AF and diabetes duration (P <0.05), and between AF and glycated hemoglobin (HbA1c) (P <0.05). CONCLUSIONS: AF measurement is a simple and noninvasive method of assessing AGE accumulation in the skin. It may be useful as a secondary method of assessing metabolic control, as it reflects glycemic control over a longer period of time than that reflected by HbA1c levels.