Skin autofluorescence is associated with high-sensitive cardiac troponin T, a circulating cardiac biomarker, in Japanese patients with diabetes: A cross-sectional study.

The study aims to evaluate the relationship between skin autofluorescence, a marker of advanced glycated end-products accumulation in tissue, and high-sensitive cardiac troponin T, a cardiovascular biomarker, in Japanese subjects with diabetes. A total of 145 subjects with diabetes and 32 nondiabetic subjects as control attending the outpatient clinic were examined. Skin autofluorescence was measured using the AGE Reader™. Univariate and multivariate regression analyses were used to identify the factors associated with the high-sensitive cardiac troponin T and N-terminal pro-B-type natriuretic peptide values. Skin autofluorescence, high-sensitive cardiac troponin T, and maximum intima-media thickness values were significantly higher in subjects with diabetes than in nondiabetic subjects. Diabetic subjects with skin autofluorescence level⩾2.47 AU (median value) had higher levels of N-terminal pro-B-type natriuretic peptide ( p = 0.006), high-sensitive cardiac troponin T ( p < 0.0001), pentosidine ( p = 0.011) and maximum intima-media thickness ( p = 0.017) compared to those with skin autofluorescence level <2.47 AU. A multivariate regression analysis using variables that were significantly correlated with high-sensitive cardiac troponin T and N-terminal pro-B-type natriuretic peptide, revealed that estimated glomerular filtration rate (β = -0.364, p < 0.001) and skin autofluorescence (β = 0.254, p  = 0.0022) were independent determinants of high-sensitive cardiac troponin T, but the variables that were significant in the univariate analysis were no longer predictors for N-terminal pro-B-type natriuretic peptide. Skin autofluorescence measured with the AGE Reader™ could be an easy and noninvasive surrogate marker for identifying diabetic subjects at high risk for subclinical cardiac injury.