Iran: Study on Skin Autofluorescence and Diabetes

Results from a meta-analysis revealed that increased skin autofluorescence levels are associated with glycated hemoglobin, diabetic peripheral neuropathy, diabetic nephropathy, diabetic micro and macrovascular events, and diabetic retinopathy. Further, skin autofluorescence levels were correlated with diabetes duration, age, and maximum carotid intima-media thickness level. The study was published in the journal EClinicalMedicine on November 15, 2021.

One of the main factors causing diabetic end-organ damage, accumulation of long half-life proteins, such as skin and cartilage collagen, is advanced glycation end products (AGE). Measurement of AGE may provide additional evidence for predicting diabetic vascular complications. Skin autofluorescence (SAF) is shown to be a non-invasive, quick, and reliable method for measuring tissue AGE level.

Against the above background, Zahra Razavi, Department of Dermatology, Razi Hospital, Tehran University of Medical Science, Tehran, Iran, and colleagues aimed to review and evaluate evidence on the clinical validation of SAF measurement in diabetes mellitus (DM) patients.

For this purpose, the researchers searched the online databases from their inception to 10 August 2021 for observational studies concerning SAF measurement in diabetic patients. The studies which included DM patients and estimated their AGE using SAF were included in the meta-analysis. For meta-analyzing the clinical validation of SAF in DM with particular emphasis on chronic diabetes complications, random-effect models were used.

881 records were identified and twenty-nine records fulfilled the eligibility criteria and were included in the systematic review and meta-analysis.

Salient Findings of the Study

• A statistically significant correlation was found between SAF and diabetes last HbA1c 0.21 in studies with substantial heterogeneity (I²=77.99%).
• A significant positive association between SAF level and diabetic retinopathy (DR) [(OR= 1.05), (I²=63.78%)], diabetic peripheral neuropathy (DPN) [(OR= 1.11), (I²=79.17%)], diabetic nephropathy (DNP) [(OR= 1.08), (I²=65.36%)] and diabetic macrovascular events (D-MVE) [(OR=1.08) (I²=67.32)] were found.

"Findings confirm the significance of SAF measurement as a non-invasive surrogate marker of DM micro and macrovascular complications," wrote the authors. This implies that skin AGE estimation may be a useful factor for the prediction and early detection of irreversible DM complications. However, there is a need for more studies with larger populations and longer follow-up periods.

Reference

The study titled, "Clinical significance of non-invasive skin autofluorescence measurement in patients with diabetes: a systematic review and meta-analysis," was published in the Lancet journal EClinicalMedicine.

DOI: https://doi.org/10.1016/j.eclinm.2021.101194