1 型糖尿病并发症患者组织自发荧光的无创测量值增加，并与血管功能障碍的无创测量值相关。
Non-invasive measures of tissue autofluorescence are increased in Type 1 diabetes complications and correlate with a non-invasive measure of vascular dysfunction.
机构信息
Department of Medicine, University of Melbourne, St Vincent's Hospital, Melbourne, Australia.
出版信息
Diabet Med. 2012 Jun;29(6):726-33. doi: 10.1111/j.1464-5491.2011.03562.x.
OBJECTIVE
To determine if ocular and skin autofluorescence, reflecting advanced glycation end-products, and vascular stiffness correlate in non-diabetic and Type 1 diabetic subjects and if levels differ by diabetes status.
RESEARCH DESIGN AND METHODS
Patients with Type 1 diabetes (n = 69, 19 with and 50 without vascular complications) and 60 subjects without diabetes (control) had ocular and skin autofluorescence and pulse-wave analysis performed in the fasted state. Correlations between measures within groups used the Pearson or Spearman correlation-coefficient and measures between groups were compared by ANOVA.
RESULTS
Lens and skin autofluorescence correlated in control (r = 0.58, P = 0.0001) and in Type 1 diabetes (r = 0.53, P = 0.001). Corneal autofluorescence correlated with lens (r = 0.53, r = 0.52, P = 0.0001) and skin autofluorescence (r = 0.34, P = 0.01 and r = 0.49, P = 0.00001) in control and Type 1 diabetes respectively. In Type 1 diabetes, small and large artery elasticity correlated inversely and systemic vascular resistance correlated positively with skin autofluorescence (all P = 0.001), and with lens and corneal autofluorescence (all P < 0.03). In Type 1 diabetes tissue advanced glycation end-products correlated with C-reactive protein and inversely with the estimated glucose disposal rate and with circulating advanced glycation end-product levels. Relative to non-diabetic subjects, lens, corneal and skin fluorescence were increased (all P < 0.001) and small artery elasticity was decreased in diabetes (P = 0.04). Lens, corneal and skin autofluorescence were greater (all P = 0.0001) in patients with Type 1 diabetes with complications compared to those without complications, but small artery elasticity did not differ significantly.
CONCLUSIONS
Ocular and skin autofluorescence and vascular stiffness correlate in non-diabetic and Type 1 diabetes subjects and are increased in Type 1 diabetes. Tissue advanced glycation end-products correlate with vascular risk factors, including circulating advanced glycation end-products.
目的
确定在非糖尿病和 1 型糖尿病患者中，反映晚期糖基化终产物的眼部和皮肤自发荧光与血管僵硬是否相关，以及这些水平是否因糖尿病状态而异。
研究设计和方法
69 例 1 型糖尿病患者（19 例有血管并发症，50 例无血管并发症）和 60 例无糖尿病的受试者（对照组）在空腹状态下进行眼部和皮肤自发荧光和脉搏波分析。组内测量值之间的相关性使用 Pearson 或 Spearman 相关系数，组间测量值的比较采用 ANOVA。
结果
在对照组（r = 0.58，P = 0.0001）和 1 型糖尿病患者（r = 0.53，P = 0.001）中，晶状体和皮肤自发荧光相关。角膜自发荧光与晶状体（r = 0.53，r = 0.52，P = 0.0001）和皮肤自发荧光（r = 0.34，P = 0.01 和 r = 0.49，P = 0.00001）在对照组和 1 型糖尿病患者中均相关。在 1 型糖尿病患者中，小动脉和大动脉弹性呈负相关，全身血管阻力与皮肤自发荧光呈正相关（均 P = 0.001），与晶状体和角膜自发荧光也呈正相关（均 P < 0.03）。在 1 型糖尿病中，组织晚期糖基化终产物与 C 反应蛋白呈负相关，与估计的葡萄糖处置率和循环晚期糖基化终产物水平呈正相关。与非糖尿病患者相比，糖尿病患者的晶状体、角膜和皮肤荧光均增加（均 P < 0.001），小动脉弹性降低（P = 0.04）。与无并发症的患者相比，1 型糖尿病伴并发症患者的晶状体、角膜和皮肤自发荧光均显著增加（均 P = 0.0001），但小动脉弹性无显著差异。
结论
在非糖尿病和 1 型糖尿病患者中，眼部和皮肤自发荧光与血管僵硬相关，并且在 1 型糖尿病中增加。组织晚期糖基化终产物与血管危险因素相关，包括循环晚期糖基化终产物。
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