Banser Alena, Naafs Jolanda C, Hoorweg-Nijman Jantine Jg, van de Garde Ewoudt Mw, van der Vorst Marja Mj
Faculty of Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands.
Department of Pediatrics, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
Pediatr Diabetes. 2016 Sep;17(6):426-32. doi: 10.1111/pedi.12311. Epub 2015 Sep 2.
Advanced glycation end products (AGEs) are considered major contributors to microvascular and macrovascular complications in adult patients with diabetes mellitus. AGEs can be measured non-invasively with skin autofluorescence (sAF). The primary aim was to determine sAF values in children with type 1 diabetes mellitus and to study correlations between sAF values and HbA1c and mean HbA1c over the year prior to measurement
In children with type 1 diabetes mellitus, sAF values were measured using the AGE Reader®. Laboratory and anthropometric values were extracted from medical charts. Correlations were studied using Pearson's correlation coefficient. Multivariable linear regression analysis was conducted to evaluate the effect of multiple study parameters on sAF values.
The mean sAF value was 1.33 ± 0.36 arbitrary units (AU) in children with type 1 diabetes mellitus (n = 144). sAF values correlated positively with HbA1c measured at the same time (r = 0.485; p < 0.001), mean HbA1c over the year prior to measurement (r = 0.578; p < 0.001), age (r = 0.337; p < 0.001), duration of type 1 diabetes mellitus (r = 0.277; p = 0.001), serum triglycerides (r = 0.399; p < 0.001), and total cholesterol (r = 0.352; p = 0.001). sAF values were significantly higher in patients with non-white skin (1.56 vs. 1.27 AU, respectively, p = 0.001).
In children with type 1 diabetes, sAF values correlate strongly with single HbA1c and mean HbA1c, making the non-invasive sAF measurement an interesting alternative to provide information about cumulative hyperglycemic states. To determine the value of sAF measurement in predicting long-term microvascular and macrovascular complications, further prospective follow-up studies are needed.
晚期糖基化终末产物（AGEs）被认为是成年糖尿病患者微血管和大血管并发症的主要促成因素。AGEs可通过皮肤自发荧光（sAF）进行无创测量。主要目的是确定1型糖尿病儿童的sAF值，并研究sAF值与糖化血红蛋白（HbA1c）以及测量前一年的平均HbA1c之间的相关性。
使用AGE Reader®测量1型糖尿病儿童的sAF值。从病历中提取实验室和人体测量值。使用Pearson相关系数研究相关性。进行多变量线性回归分析以评估多个研究参数对sAF值的影响。
1型糖尿病儿童（n = 144）的平均sAF值为1.33±0.36任意单位（AU）。sAF值与同时测量的HbA1c呈正相关（r = 0.485；p < 0.001），与测量前一年的平均HbA1c呈正相关（r = 0.578；p < 0.001），与年龄呈正相关（r = 0.337；p < 0.001），与1型糖尿病病程呈正相关（r = 0.277；p = 0.001），与血清甘油三酯呈正相关（r = 0.399；p < 0.001），与总胆固醇呈正相关（r = 0.352；p = 0.001）。非白种皮肤患者的sAF值显著更高（分别为1.56 AU和1.27 AU，p = 0.001）。
在1型糖尿病儿童中，sAF值与单次HbA1c和平均HbA1c密切相关，使得无创sAF测量成为提供累积高血糖状态信息的一个有趣的替代方法。为了确定sAF测量在预测长期微血管和大血管并发症方面的价值，还需要进一步的前瞻性随访研究。
