Skin Autofluorescence Profile in Tunisian Subjects with and Without Metabolic Disorders

Background: The AGE Reader, as a clinical tool for non invasive assessment, measures the accumulation of advanced glycation end products (AGEs) in skin tissues shown as skin autofluorescence (SAF). AGEs Accumulation has been implicated in several diseases. There is no data about SAF profile in Tunisian population, this study aimed to assess firstly SAF profile in subjects with and without metabolic disorders and secondly to examine the association between SAF and various clinical parameters.Methods: In a cross-sectional study, we included 220 participants between 19 and 86 years of age who were subdivided in two groups: a healthy group (n=93) and patients group with metabolic disorders (n=127) contains three subgroups as following: diabetic patients (n=32), hypertensive patients (n=54) and patients with both diabetes and hypertension (n=41). Skin AGEs accumulation was measured by AGE Reader and clinical data was obtained.Results: SAF was significantly higher in patients group compared to healthy group [2.40 AU (2.10-2.60) vs. 2.00 AU (1.70-2.10) respectively; P <0.001]. Diabetic patients and hypertensive patients showed an increased level of SAF. The highest of SAF was observed in patient with both coexistence of diabetes, hypertension and dyslipidemia. SAF was associated with age, gender, BMI, duration of diabetes, HbA1c, triglyceride and obesity. Multivariate analysis showed that age and duration of diabetes were independent determinant of SAF. The ROC analysis indicated that an SAF > 2.25 AU was optimal cut-off point to predict the presence of metabolic disorders (P <0.001). Conclusion: SAF was increased in patients with diabetes and/or with hypertension and dyslipidemia. AGE Reader device is a rapid and helpful tool in clinical practice for evaluating and screening metabolic disorders in undiagnosed subjects.

Relationship between skin autofluorescence levels and clinical events in patients with heart failure undergoing cardiac rehabilitation

Background Advanced glycation end-products, indicated by skin autofluorescence (SAF) levels, could be prognostic predictors of all-cause and cardiovascular mortality in patients with diabetes mellitus (DM) and renal disease. However, the clinical usefulness of SAF levels in patients with heart failure (HF) who underwent cardiac rehabilitation (CR) remains unclear. This study aimed to investigate the associations between SAF and MACE risk in patients with HF who underwent CR. Methods This study enrolled 204 consecutive patients with HF who had undergone CR at our university hospital between November 2015 and October 2017. Clinical characteristics and anthropometric data were collected at the beginning of CR. SAF levels were noninvasively measured with an autofluorescence reader. Major adverse cardiovascular event (MACE) was a composite of all-cause mortality and unplanned hospitalization for HF. Follow-up data concerning primary endpoints were collected until November 2017. Results Patients’ mean age was 68.1 years, and 61% were male. Patients were divided into two groups according to the median SAF levels (High and Low SAF groups). Patients in the High SAF group were significantly older, had a higher prevalence of chronic kidney disease, and more frequently had history of coronary artery bypass surgery; however, there were no significant between-group differences in sex, prevalence of DM, left ventricular ejection fraction, and physical function. During a mean follow-up period of 590 days, 18 patients had all-cause mortality and 36 were hospitalized for HF. Kaplan–Meier analysis showed that patients in the high SAF group had a higher incidence of MACE (log-rank P < 0.05). After adjusting for confounding factors, Cox regression multivariate analysis revealed that SAF levels were independently associated with the incidence of MACE (odds ratio, 1.86; 95% confidence interval, 1.08–3.12; P = 0.03). Conclusion SAF levels were significantly associated with the incidence of MACE in patients with HF and may be useful for risk stratification in patients with HF who underwent CR.

Higher habitual intake of dietary dicarbonyls is associated with higher corresponding plasma dicarbonyl concentrations and skin autofluorescence: The Maastricht Study

Background Dicarbonyls are highly reactive compounds and major precursors of advanced glycation endproducts (AGEs). Both dicarbonyls and AGEs are associated with development of age-related diseases. Dicarbonyls are formed endogenously, but also during food processing. To what extent dicarbonyls from the diet contribute to circulating dicarbonyls and AGEs in tissues is unknown. Objective To examine cross-sectional associations of dietary dicarbonyl intake with plasma dicarbonyl concentrations and skin AGEs. Design In 2566 individuals of the population based Maastricht Study (age: 60±8 yrs, 50% males, 26% type 2 diabetes), we estimated habitual intake of the dicarbonyls methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG), by combining Food Frequency Questionnaires with our dietary dicarbonyl database of MGO, GO, and 3-DG concentrations in &gt;200 commonly-consumed food products. Fasting plasma concentrations of MGO, GO, and 3-DG were measured by UPLC-MS/MS. Skin AGEs were measured as skin autofluorescence (SAF), using the AGE-Reader. Associations of dietary dicarbonyl intake with their respective plasma concentrations and SAF (all standardized) were examined using linear regression models, adjusted for age, sex, potential confounders related to cardio-metabolic risk factors and lifestyle. Results Median intake of MGO, GO, and 3-DG was 3.6, 3.5, and 17 mg/day, respectively. Coffee was the main dietary source of MGO, whereas this was bread for GO and 3-DG. In the fully adjusted models, dietary MGO was associated with plasma MGO (β = 0.08, 95%CI [0.02,0.13]) and SAF (β = 0.12 [0.07,0.17]). Dietary GO was associated with plasma GO (β = 0.10 [0.04,0.16]) but not with SAF. 3-DG was not significantly associated with either plasma 3-DG or SAF. Conclusions Higher habitual intake of dietary MGO and GO, but not 3-DG, was associated with higher corresponding plasma concentrations. Higher intake of MGO was also associated with higher SAF. These results suggest dietary absorption of MGO and GO. Biological implications of dietary absorption of MGO and GO need to be determined. Clinical Trial Registry number: The study has been approved by the institutional medical ethical committee (NL31329.068.10) and the Minister of Health, Welfare and Sports of the Netherlands (Permit 131088-105234-PG).

Skin autofluorescence profile in Tunisian hemodialysis patients with and without heart failure

Background Cardiovascular disease (CVD) is the main reason for morbidity and mortality of patients in hemodialyis. Skin autofluorescence (SAF), a noninvasive measurement method, reflects tissue accumulation of advanced glycation end products (AGEs) that has been implicated in CVD as a strong marker. The aim of this study was to evaluate SAF profile in hemodialysis patients and to assess the association between SAF and heart failure. Methods In a cross-sectional study, we included 60 hemodialysis (HD) patients who were subdivided in two groups: a HD group without heart failure (n = 42) and a HD group with heart failure (n = 18). Skin AGEs accumulation was measured by AGE Reader device and clinical data was obtained. Results HD patients showed a SAF value at 2.90 (2.40–3.60). HD patients with diabetes mellitus have an increased SAF levels compared to HD patients without diabetes [3.20 (2.90–3.95) vs. 2.70 (2.30–3.30) AU, P = 0.021; respectively]. Furthermore, HD patients with heart failure showed a significant increased SAF levels compared to HD patients without heart failure [3.65 (2.90–4.12) vs. 2.60 (2.30–3.20) AU, P < 0.001; respectively]. SAF was associated with age, gender, and duration of dialysis. The ROC analysis indicated that SAF at 3.05 AU was optimal cut-off point for presence of heart failure (P < 0.001). Conclusion SAF might be a rapid and helpful tool in clinical practice as a potential marker for evaluating and screening heart failure in HD patients non-invasively and might be used as predictor for clinicians.