Krul-Poel Y H M, Agca R, Lips P, van Wijland H, Stam F, Simsek S
Department of Internal Medicine, Medical Centre Alkmaar, PO Box 7057, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
Department of Internal Medicine/Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands.
Cardiovasc Diabetol. 2015 Jul 16;14:89. doi: 10.1186/s12933-015-0250-z.
Skin autofluorescence is a non-invasive measurement of advanced glycation end products (AGE), which are suggested to be one of the major agents in the pathogenesis and progression of diabetes related cardiovascular complications. Recently, low vitamin D status has been linked to the progression of type 2 diabetes mellitus (T2DM) and cardiovascular disease. The aim of this study is to investigate the association between vitamin D status and skin autofluorescence in patients with T2DM.
In this preliminary report skin autofluorescence was measured non-invasively with an AGE-reader in 245 patients with T2DM treated with lifestyle advice, metformin and/or sulphonylurea-derivatives. All patients were randomly assigned to receive either vitamin D 50,000 IU/month or placebo for 6 months.
Skin autofluorescence was significantly higher in patients with a serum 25(OH)D < 50 nmol/l compared to patients with a serum 25(OH)D > 75 nmol/l (2.81 versus 2.41; p < 0.001). Mean serum 25(OH)D was 60.3 ± 23.4 nmol/l and was independently associated with skin autofluorescence (β -0.006; p < 0.001). Mean vitamin D increased from 60.8 to 103.6 nmol/l in the intervention group, however no effect was seen on accumulation of skin AGEs after 6 months compared to placebo.
Vitamin D status is independently associated with skin auto fluorescence in patients with well-controlled T2DM. No effect was seen on the amount of skin AGEs after a short period of 6 months vitamin D supplementation. Further research with longer follow-up and measurement of circulating advanced glycation end products is needed to elucidate the causality of the association.
皮肤自发荧光是对晚期糖基化终产物(AGE)的一种非侵入性测量,晚期糖基化终产物被认为是糖尿病相关心血管并发症发病机制和进展的主要因素之一。最近,低维生素D状态与2型糖尿病(T2DM)和心血管疾病的进展有关。本研究的目的是调查T2DM患者维生素D状态与皮肤自发荧光之间的关联。
在本初步报告中,使用AGE读数仪对245例接受生活方式建议、二甲双胍和/或磺脲类衍生物治疗的T2DM患者进行了非侵入性皮肤自发荧光测量。所有患者被随机分配接受每月50,000 IU维生素D或安慰剂,为期6个月。
血清25(OH)D<50 nmol/l的患者皮肤自发荧光显著高于血清25(OH)D>75 nmol/l的患者(2.81对2.41;p<0.001)。平均血清25(OH)D为60.3±23.4 nmol/l,且与皮肤自发荧光独立相关(β -0.006;p<0.001)。干预组平均维生素D从60.8 nmol/l增加到103.6 nmol/l,但与安慰剂相比,6个月后皮肤AGEs积累未见影响。
在血糖控制良好的T2DM患者中,维生素D状态与皮肤自发荧光独立相关。补充维生素D 6个月的短期内,皮肤AGEs量未见影响。需要进一步进行更长时间随访和循环晚期糖基化终产物测量的研究,以阐明这种关联的因果关系。