The association between skin auto-fluorescence of palmoplantar sites and microvascular complications in Asian patients with type 2 diabetes mellitus

Abstract

Skin auto-fluorescence (SAF) has generated broad interest about the prospects for non-invasive advanced glycation end product assessment and its direct interplay with the development of microvascular complications, but clinical application of the existing SAF measuring of non-palmoplantar sites in non-Caucasian subjects with dark skin type is still controversial. Here, we tested the diabetic complication screening performance of a novel SAF measuring system in Asian type 2 diabetes mellitus (T2DM) subjects. A total of 166 Korean patients with T2DM were enrolled in this study and palmoplantar SAF was measured by a newly developed transmission-geometry noninvasive optical system. We found that transmitted SAF values of palmoplantar sites, 1st dorsal interossei muscles of the hand, in a complication group were significantly higher than in a non-complication group while no differences were observed between the two groups in reflected SAF of non-palmoplantar sites. The transmitted SAF values of palmoplantar sites were dramatically increased in subjects with multiple complications and were tightly correlated with the duration of microvascular complications. In conclusion, the SAF measurement in the palmoplantar sites with a non-invasive transmission-geometry optical system provided better microvascular complication screening performance compared to the SAF measurement of non-palmoplantar sites specifically in Asian T2DM subjects.

Non‐invasive skin autofluorescence as a screening method for diabetic retinopathy

“…The prevalence of DR in the sample ranged from 31.3% to 75.0% among diabetic participants. All studies measured AGEs in the forearm with SAF, except one that measured AGEs in the palm of the hand 44 . The device used to measure SAF differed among studies.…”

“…There is a paucity of information on test analysis and one of the studies does not show SAF test specificity data for DR, so we decided to use the data for microvascular complications in general. 44 There are unreported data in the studies, so it is not possible to assess whether some factors were considered.…”

“…A total of 171 articles were retrieved from the literature search, from which five articles were included in this systematic review and metaanalysis (Figure 1). [42][43][44][45][46] The five studies included 2403 participants, of whom 2025 were patients with diabetes. AGEs in the palm of the hand.…”

“…AGEs in the palm of the hand. 44 The device used to measure SAF differed among studies. All studies provided information on patient sex, smoking status, baseline value of AGEs, and DR severity, especially distinguishing between non-proliferative and proliferative DR.…”

Is skin autofluorescence (SAF) representative of dermal advanced glycation endproducts (AGEs) in dark skin? A pilot study

“…However, a recent study by Kim et al. [ 23 ] found that, using a novel SAF instrument, SAF was significantly higher at palmoplantar sites in Asian subjects with T2D complications, as compared to those without. No differences were observed between these groups in SAF of non-palmoplantar sites.…”