Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey.
Department of Endocrinology and Metabolism, Ersin Arslan Training and Research Hospital, Gaziantep, Turkey.
Obes Surg. 2021 Mar;31(3):1055-1061. doi: 10.1007/s11695-020-05077-z. Epub 2020 Oct 29.
Advanced glycation end product (AGE) is a marker of metabolic memory. Accumulated AGEs in skin collagen measured with skin autofluorescence (SAF) was found to be associated with subclinical atherosclerosis. We aimed to evaluate SAF and carotid intima-media thickness (CIMT) and its association with clinical and biochemical parameters in severely obese patients before and after bariatric surgery.
In this observational study, 432 morbid obese patients evaluated before and after 6 and 12 months of bariatric surgery for metabolic and anthropometric parameters, CIMT and SAF. SAF was assessed in the forearm with an AGE Reader.
SAF measurements were higher in diabetic (2.04 ± 0.52 AU) obese patients compared to non-diabetic (1.78 ± 0.40 AU) obese patients (p < 0.0001). Although bariatric surgery-induced weight loss resulted in a decrease in CIMT in the 6th and 12th months compared to baseline, weight loss and metabolic improvements were not associated with a parallel decrease in SAF measurements. SAF measurements were positively correlated with body mass index (r 0.527, p < 0.0001), HbA1c (r 0.362, p < 0.0001), and CIMT (r 0.319, p < 0.0001). Multivariate analysis showed the presence of diabetes (but not BMI, age, and sex) was independently associated with SAF (R = 7.62%), and the presence of diabetes, low-density cholesterol, and systolic blood pressure were independently associated with CIMT measurements (R = 21.7%).
Bariatric surgery-induced weight loss and metabolic improvement were found to be associated with improvement in CIMT, while skin AGE accumulation was not regressed in the first year of surgery.
糖基化终产物（AGE）是代谢记忆的标志物。皮肤胶原中通过皮肤自发荧光（SAF）测量的累积 AGE 与亚临床动脉粥样硬化有关。我们旨在评估严重肥胖患者在减肥手术前后的 SAF 和颈动脉内膜中层厚度（CIMT）及其与临床和生化参数的相关性。
在这项观察性研究中，对 432 名接受减肥手术的病态肥胖患者进行了评估，以评估代谢和人体测量参数、CIMT 和 SAF，这些患者在减肥手术后 6 个月和 12 个月进行了评估。使用 AGE 阅读器在手前臂评估 SAF。
与非糖尿病肥胖患者（1.78±0.40 AU）相比，糖尿病肥胖患者（2.04±0.52 AU）的 SAF 测量值更高（p<0.0001）。尽管减肥手术后体重减轻导致第 6 个月和第 12 个月与基线相比 CIMT 降低，但体重减轻和代谢改善与 SAF 测量值的平行降低无关。SAF 测量值与体重指数（r=0.527，p<0.0001）、HbA1c（r=0.362，p<0.0001）和 CIMT（r=0.319，p<0.0001）呈正相关。多变量分析显示，糖尿病的存在（而非 BMI、年龄和性别）与 SAF 独立相关（R=7.62%），糖尿病、低密度胆固醇和收缩压的存在与 CIMT 测量独立相关（R=21.7%）。
减肥手术引起的体重减轻和代谢改善与 CIMT 的改善相关，而在手术的第一年，皮肤 AGE 积累没有消退。
