Skin Autofluorescence Reflects Vascular Damage in Type 2 Diabetes

Skin autofluorescence, as a measure of the accumulation of advanced glycation end products (AGEs) in tissue, may serve as an indicator of vascular damage in patients with type 2 diabetes, according to a new report. "By linking skin autofluorescence to AGE accumulation and, therefore, to cumulative glycemic and oxidative damage in diabetes, we aim to create a tool that is able to give a rapid impression of the risk for diabetes complications," the authors explain.

Dr. Helen L. Lutgers from University Medical Center Groningen, the Netherlands, and colleagues investigated the association between skin autofluorescence and micro- and macrovascular complications in 973 patients with type 2 diabetes.

Autofluorescence was measured on the volar side of the forearm, by illuminating the skin with an 8 W blacklight and quantifying the levels of emission light.

Mean skin autofluorescence was 33% higher among type 2 diabetics than among controls, the investigators report, and this difference persisted across age categories.

Patients with both micro- and macrovascular complications had higher mean skin autofluorescence than did patients without complications and patients with only microvascular complications. Patients with macrovascular complications also had higher mean skin autofluorescence than did patients without complications, the researchers note.

Increased skin autofluorescence was also associated with increased age, female sex, current tobacco use, increased diabetes duration, increased plasma creatinine and glycated hemoglobin, and decreased HDL cholesterol, the report indicates.

"In this study, we showed that increased levels of skin autofluorescence [were] related to the extent of diabetes-related complications," the authors conclude.

"In a 4-year follow-up study," they add, "the progression of micro- and macrovascular complications, as well as mortality, is now (being) evaluated in the current study group of type 2 diabetic patients to analyze whether skin autofluorescence contributes to the prediction of the development or progression of diabetes complications."

Diabetes Care 2006;29:2654-2659.