1. Skin autofluorescence predicts new cardiovascular disease and mortality in people with type 2 diabetes
- Author
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Henderikus E. Boersma, Melanie M. van der Klauw, Andries J. Smit, Reindert Graaff, Robert P. van Waateringe, Andrew D. Paterson, Bruce H. R. Wolffenbuttel, Life Course Epidemiology (LCE), Groningen Kidney Center (GKC), and Center for Liver, Digestive and Metabolic Diseases (CLDM)
- Subjects
Blood Glucose ,Male ,Diabetic Cardiomyopathies ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Type 2 diabetes ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Cohort Studies ,Skin autofluorescence ,Medicine ,Skin ,education.field_of_study ,Incidence (epidemiology) ,Incidence ,Diabetes ,General Medicine ,Middle Aged ,Cardiovascular disease ,Cholesterol ,Cardiovascular Diseases ,Female ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,Statin ,medicine.drug_class ,Population ,Fluorescence ,Sex Factors ,Predictive Value of Tests ,Internal medicine ,Diabetes mellitus ,Humans ,Mortality ,education ,Aged ,Glycated Hemoglobin ,lcsh:RC648-665 ,business.industry ,Insulin ,fungi ,medicine.disease ,Atherosclerosis ,Ageing ,Blood pressure ,Diabetes Mellitus, Type 2 ,business ,Prediction ,Follow-Up Studies - Abstract
Background Skin autofluorescence (SAF) is a non-invasive marker of tissue accumulation of advanced glycation endproducts (AGE). Recently, we demonstrated in the general population that elevated SAF levels predict the development of type 2 diabetes (T2D), cardiovascular disease (CVD) and mortality. We evaluated whether elevated SAF may predict the development of CVD and mortality in individuals with T2D. Methods We included 2349 people with T2D, available baseline SAF measurements (measured with the AGE reader) and follow-up data from the Lifelines Cohort Study. Of them, 2071 had no clinical CVD at baseline. 60% were already diagnosed with diabetes (median duration 5, IQR 2–9 years), while 40% were detected during the baseline examination by elevated fasting blood glucose ≥7.0 mmol/l) and/or HbA1c ≥6.5% (48 mmol/mol). Results Mean (±SD) age was 57 ± 12 yrs., BMI 30.2 ± 5.4 kg/m2. 11% of participants with known T2D were treated with diet, the others used oral glucose-lowering medication, with or without insulin; 6% was using insulin alone. Participants with known T2D had higher SAF than those with newly-detected T2D (SAF Z-score 0.56 ± 0.99 vs 0.34 ± 0.89 AU, p p p p Conclusions Measuring SAF can assist in prediction of incident cardiovascular disease and mortality in individuals with T2D. SAF showed a stronger association with future CVD events and mortality than cholesterol or blood pressure levels.
- Published
- 2021