Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, G. Kondyli 22c, 68100, Alexandroupolis, Greece.
BMC Endocr Disord. 2021 Feb 23;21(1):28. doi: 10.1186/s12902-021-00697-7.
Advanced glycation end-products (AGEs) are heterogeneous molecules produced by the non-enzymatic glycation of proteins, lipids, or nucleic acids during hyperglycaemia. Accumulation of AGEs in the peripheral nerves has recently been proposed as an additional risk factor for the development of diabetic neuropathy (DN). The gold standard for measurement of tissue-bound AGEs is tissue biopsy. However, their assessment with the newer, fast and simple method of skin autofluorescence (sAF) has recently gained special interest by virtue of its non-invasive, highly reproducible nature and its acceptable correlation with the reference method of skin biopsy. Accumulation of tissue AGEs evaluated by sAF has been shown to independently correlate with DN. Importantly, increasing evidence underscores their potential value as early biomarkers of the latter. Further important associations include diabetic nephropathy, diabetic retinopathy and cardiovascular autonomic neuropathy. However, the value of the implementation of screening with skin AGEs for DN remains unclear. The aim of the present review is to critically summarise current evidence on the association between skin AGEs and diabetic microvascular complications, with a particular emphasis on diabetic neuropathy, and to note the most important limitations of existing knowledge. Longer follow-up studies are also highly anticipated to clarify its role and provide data on patient selection and cost-effectiveness.
糖基化终产物 (AGEs) 是在高血糖条件下蛋白质、脂质或核酸非酶糖化产生的异质分子。最近有人提出，外周神经中 AGEs 的积累是糖尿病性神经病变 (DN) 发展的另一个危险因素。测量组织结合型 AGEs 的金标准是组织活检。然而，由于其非侵入性、高度可重复性以及与皮肤活检参考方法的可接受相关性，其新的、快速且简单的皮肤自发荧光 (sAF) 评估方法最近引起了特别关注。sAF 评估的组织 AGEs 积累与 DN 独立相关。重要的是，越来越多的证据强调了它们作为后者早期生物标志物的潜在价值。进一步的重要关联包括糖尿病肾病、糖尿病视网膜病变和心血管自主神经病变。然而，皮肤 AGEs 筛查用于 DN 的实施价值仍不清楚。本综述的目的是批判性地总结皮肤 AGEs 与糖尿病微血管并发症之间的关联的现有证据，特别强调糖尿病性神经病变，并注意现有知识的最重要局限性。人们还高度期待进行更长时间的随访研究，以阐明其作用，并提供有关患者选择和成本效益的数据。
