Skin autofluorescence predicts cardio-renal outcome in type 1 diabetes: a longitudinal study

Cardiovascular Diabetology

Original Investigation

Cyril Astrugue¹  Catherine Helmer¹  Sovanndany Nov¹  Blandine Farges²  Laurence Blanco²  Emilie Pupier²  Henri Gin²  Marie Hugo²  Kalina Rajaobelina³  Vincent Rigalleau³  Fritz-Line Vélayoudom-Céphise⁴ 

[1] INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France;Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France;Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France;INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France;Nutrition Diabetology Unit, CHU of Bordeaux, Haut Lévêque Hospital, Pessac, France;Research Group Clinical Epidemiology and Medicine ECM/L.A.M.I.A, EA 4540, University of Antilles, Guadeloupe, France;Department of Diabetology-Endocrinology, University Hospital of Pointe-à-Pitre, Guadeloupe, France;

关键词: Type 1 diabetes;    Skin autofluorescence;    Macrovascular events;    Albumin excretion rate;    Estimated glomerular filtration rate;   

DOI  :  10.1186/s12933-016-0448-8

 received in 2016-06-11, accepted in 2016-08-23,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWe aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascular events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D).MethodsTwo hundred and forty-three patients (51.2 ± 16.7 years old) with T1D participated. SAF was measured by AGE-Reader-TM at inclusion. Macrovascular events (MVE), estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (AER) were recorded then and 4 years later. Multivariate logistic regression was used to analyze the relationships between SAF and incident MVE and renal profile 4 years later.ResultsPatients with incident MVE had a higher SAF (p = 0.003). SAF predicted incident MVE after adjustment for age, sex, body mass index, tobacco, diabetes duration, hypertension, HbA1c, AER, eGFR (OR 4.84 [95 % CI 1.31–17.89], p = 0.018). However, this relation was no longer significant after adjustment for history of MVE. An inverse relation was found between SAF and incident eGFR (p = 0.0001). Patients with incident eGFR <60 ml/min/1.73 m2 had a SAF higher than patients with normal eGFR. After adjustment for the previous criteria, SAF remained associated with the risk of impaired incident eGFR (OR 7.42 [95 % CI 1.59–34.65], p = 0.018). No relation was found between SAF and increased AER 4 years later.ConclusionsSAF predicts MVE in patients with T1D, adjusted for cardiovascular risk factors but the most powerful predictive factor remains history of MVE. SAF also predicts eGFR impairment, adjusted for initial AER and renal function. SAF could be a useful non-invasive tool for estimating risk of cardiovascular or renal impairment in patients with T1D.

【 授权许可】

CC BY   
© The Author(s) 2016