D.YEO1, J.J.LIU1, J.RAHIM1, N.J.NANIMAIR1, Y.M.SHAO1, S.C.LIM1
Khoo Teck Puat Hospital1
Advanced Glycation End Products (AGE) play a key pathological role in diabetic micro- and macrovascular complications. Conventional methods for AGE measurement are costly and time-consuming. We sought to study whether skin auto-fluorescence (SAF), a quick, non-invasive, and inexpensive measurement of AGE, is associated with diabetic retinopathy and long-term glycaemic control in individuals with type 2 diabetes.
166 Chinese subjects from KTPH DORIS cohort were included in this cross-sectional study. SAF was measured using AGE reader, in which AGE-modified skin protein emits auto-fluorescence after being excited by UV light. Association of SAF with long-term (>3 years) updated HbA1c and prevalent retinopathy was studied by linear and logistic regression, respectively.
SAF (AGE) reading is positively correlated with diabetes duration (Spearman rho=0.31, p<0.001)). Consistent with existing literature, SAF is independently associated with both gender (p=0.041) and chronological age (β=-0.025, p<0.001). Noteworthy, AGE is independently associated with prevalent retinopathy (β=-0.782, 95% CI [0.080, 1.484], p=0.029) after adjustment for known clinical risk factors including gender, age, diabetes duration, smoking, BMI, HbA1c, and Blood Pressure. Noteworthy, SAF was also found to be independently associated with long-term updated HbA1c (β=-0.114, 95% CI [0.055, 2.082], p=0.039).
AGE measured using SAF is associated with long-term glycemic control and retinopathy in Singapore Chinese diabetic population. It is worthwhile to study whether high AGE levels may predict incident retinopathy or retinopathy progression, making it an inexpensive and quick method to identify diabetic patients at higher risk of vascular complications for stratified management.