Foussard Ninon, Larroumet Alice, Rigo Marine, Mohammedi Kamel, Baillet-Blanco Laurence, Poupon Pauline, Monlun Marie, Lecocq Maxime, Devouge Anne-Claire, Ducos Claire, Liebart Marion, Battaglini Quentin, Rigalleau Vincent
Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France.
BMJ Open Diabetes Res Care. 2021 Mar;9(1). doi: 10.1136/bmjdrc-2020-001312.
Subjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by measuring the skin autofluorescence. We searched whether the skin autofluorescence could predict new cancers in persons with type 2 diabetes.
From 2009 to 2015, we measured the skin autofluorescence of 413 subjects hospitalized for uncontrolled or complicated type 2 diabetes, without any history of cancer. The participants were followed for at least 1 year and the occurrences of new cancers were compared according to their initial skin autofluorescences.
The participants were mainly men (57.9%), with poorly controlled (HbA1c 72±14 mmol/mol or 8.7%±1.8%) and/or complicated type 2 diabetes. Their median skin autofluorescence was 2.6 (2.2-3.0) arbitrary units. Forty-five new cancer cases (10.9%) were registered during 4.8±2.3 years of follow-up: 75.6% of these subjects had skin autofluorescence higher than the median (χ: p=0.001). By Cox regression analysis adjusted for age, gender, body mass index, history of smoking and renal parameters, skin autofluorescence >2.6 predicted a 2.57-fold higher risk of cancer (95% CI 1.28 to 5.19, p=0.008). This association remained significant after excluding the eight cancers that occurred in the 4 years after inclusion (OR 2.95, 95% CI 1.36 to 6.38, p=0.006). As a continuous variable, skin autofluorescence was also related to new cancers (OR 1.05, 95% CI 1.01 to 1.10, p=0.045).
Skin autofluorescence, a potential marker of glycemic memory, predicts the occurrence of cancer in subjects with type 2 diabetes. This relation provides a new clinical argument for the role of AGEs in cancer. Their estimation by measuring the skin autofluorescence may help select subjects with diabetes in cancer screening programs.
2型糖尿病患者患癌风险更高。生物学研究提示长期高血糖状态下积累的晚期糖基化终产物（AGEs）在癌症发生中可能发挥作用，但缺乏临床数据。可通过测量皮肤自发荧光来估算AGEs。我们探究了皮肤自发荧光能否预测2型糖尿病患者发生新发癌症。
2009年至2015年，我们测量了413例因2型糖尿病控制不佳或伴有并发症而住院且无癌症病史的患者的皮肤自发荧光。对参与者进行了至少1年的随访，并根据其初始皮肤自发荧光比较新发癌症的发生情况。
参与者主要为男性（57.9%），2型糖尿病控制不佳（糖化血红蛋白[HbA1c]为72±14 mmol/mol或8.7%±1.8%）和/或伴有并发症。他们的皮肤自发荧光中位数为2.6（2.2 - 3.0）任意单位。在4.8±2.3年的随访期间共登记了45例新发癌症病例（10.9%）：这些患者中75.6%的皮肤自发荧光高于中位数（χ²检验：p = 0.001）。经年龄、性别、体重指数、吸烟史和肾脏参数校正后的Cox回归分析显示，皮肤自发荧光>2.6预测患癌风险高出2.57倍（95%置信区间1.28至5.19，p = 0.008）。排除入组后4年内发生的8例癌症后，这种关联仍然显著（比值比[OR] 2.95，95%置信区间1.36至6.38，p = 0.006）。作为连续变量，皮肤自发荧光也与新发癌症相关（OR 1.05，95%置信区间1.01至1.10，p = 0.045）。
皮肤自发荧光作为血糖记忆的潜在标志物，可预测2型糖尿病患者患癌情况。这种关联为AGEs在癌症中的作用提供了新的临床依据。通过测量皮肤自发荧光对其进行评估可能有助于在癌症筛查项目中筛选糖尿病患者。
