Mater Research Institute, The University of Queensland, TRI, 37 Kent Street, Brisbane, QLD, 4102, Australia.
School of Biomedical Science and Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia.
Sci Rep. 2021 May 3;11(1):9422. doi: 10.1038/s41598-021-88786-4.
To examine if skin autofluorescence (sAF) differed in early adulthood between individuals with type 1 diabetes and age-matched controls and to ascertain if sAF aligned with risk for kidney disease. Young adults with type 1 diabetes (N = 100; 20.0 ± 2.8 years; M:F 54:46; FBG-11.6 ± 4.9 mmol/mol; diabetes duration 10.7 ± 5.2 years; BMI 24.5(5.3) kg/m) and healthy controls (N = 299; 20.3 ± 1.8 years; M:F-83:116; FBG 5.2 ± 0.8 mmol/L; BMI 22.5(3.3) kg/m) were recruited. Skin autofluorescence (sAF) and circulating AGEs were measured. In a subset of both groups, kidney function was estimated by GFR and uACR, and DKD risk defined by uACR tertiles. Youth with type 1 diabetes had higher sAF and BMI, and were taller than controls. For sAF, 13.6% of variance was explained by diabetes duration, height and BMI (P = 1.5 × 10). In the sub-set examining kidney function, eGFR and sAF were higher in type 1 diabetes versus controls. eGFR and sAF predicted 24.5% of variance in DKD risk (P = 2.2 × 10), which increased with diabetes duration (51%; P < 2.2 × 10) and random blood glucose concentrations (56%; P < 2.2 × 10). HbA and circulating fructosamine albumin were higher in individuals with type 1 diabetes at high versus low DKD risk. eGFR was independently associated with DKD risk in all models. Higher eGFR and longer diabetes duration are associated with DKD risk in youth with type 1 diabetes. sAF, circulating AGEs, and urinary AGEs were not independent predictors of DKD risk. Changes in eGFR should be monitored early, in addition to uACR, for determining DKD risk in type 1 diabetes.
为了研究在成年早期，1 型糖尿病患者与年龄匹配的对照组之间的皮肤自发荧光（sAF）是否存在差异，并确定 sAF 是否与肾脏疾病风险相关。招募了 100 名患有 1 型糖尿病的年轻成年人（20.0±2.8 岁；M:F 54:46；FBG-11.6±4.9mmol/mol；糖尿病病程 10.7±5.2 年；BMI 24.5(5.3)kg/m）和 299 名健康对照组（20.3±1.8 岁；M:F-83:116；FBG 5.2±0.8mmol/L；BMI 22.5(3.3)kg/m）。测量了皮肤自发荧光（sAF）和循环 AGEs。在两组的一个亚组中，通过 GFR 和 uACR 估计肾功能，并通过 uACR 三分位数定义 DKD 风险。1 型糖尿病患者的 sAF 和 BMI 较高，身高也高于对照组。对于 sAF，糖尿病病程、身高和 BMI 解释了 13.6%的方差（P=1.5×10）。在检查肾功能的亚组中，1 型糖尿病患者的 eGFR 和 sAF 高于对照组。eGFR 和 sAF 预测 DKD 风险的 24.5%（P=2.2×10），这一风险随着糖尿病病程的延长而增加（51%；P<2.2×10），随机血糖浓度也会增加（56%；P<2.2×10）。HbA 和循环果糖胺白蛋白在高 DKD 风险的 1 型糖尿病患者中更高。在所有模型中，eGFR 均与 DKD 风险独立相关。在患有 1 型糖尿病的年轻人中，较高的 eGFR 和较长的糖尿病病程与 DKD 风险相关。sAF、循环 AGEs 和尿 AGEs 不是 DKD 风险的独立预测因子。除 uACR 外，还应早期监测 eGFR 的变化，以确定 1 型糖尿病的 DKD 风险。
