Endocrinology and Nutrition Department, Diabetes and Metabolism (ODIM) Research Group, University Hospital Arnau de Vilanova, Obesity, IRBLleida, University of Lleida, 25198 Lleida, Spain.
Laboratory of Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Monastir 5000, Tunisia.
Nutrients. 2022 Mar 5;14(5):1102. doi: 10.3390/nu14051102.
A large body of evidence demonstrates a relationship between hyperglycemia and increased concentrations of advanced glycation end-products (AGEs). However, there is little information about subcutaneous AGE accumulation in subjects with prediabetes, and whether or not this measurement could assist in the diagnosis of prediabetes is unclear. A cross-sectional study was conducted in 4181 middle-aged subjects without diabetes. Prediabetes (n = 1444) was defined as a glycosylated hemoglobin (HbA1c) level between 39 and 47 mmol/mol (5.7 to 6.4%), and skin autofluorescence (SAF) measurement was performed to assess AGEs. A multivariable logistic regression model and receiver operating characteristic curve were used. The cohort consisted of 50.1% women with an age of 57 [52;62] years, a BMI of 28.3 [25.4;31.6] kg/m2, and a prevalence of prediabetes of 34.5%. Participants with prediabetes showed higher SAF than control participants (2.0 [1.7;2.2] vs. 1.9 [1.7;2.2], p < 0.001). However, HbA1c was not significantly correlated with SAF levels (r = 0.026, p = 0.090). In addition, the SAF level was not independently associated with prediabetes (OR = 1.12 (0.96 to 1.30)). Finally, there was no good cutoff point for SAF to identify patients with prediabetes (AUC = 0.52 (0.50 to 0.54), sensitivity = 0.61, and 1-specificity = 0.56). Given all of this evidence, we can conclude that although there is an increase in SAF levels in participants with prediabetes, the applicability and clinical relevance of the results is low in this population.
大量证据表明,高血糖与高级糖基化终产物(AGEs)浓度升高之间存在关联。然而,关于糖尿病前期患者皮下 AGE 积累的信息很少,并且这种测量方法是否有助于糖尿病前期的诊断尚不清楚。本研究进行了一项横断面研究,共纳入了 4181 名无糖尿病的中年受试者。糖尿病前期(n = 1444)定义为糖化血红蛋白(HbA1c)水平在 39 至 47 mmol/mol(5.7 至 6.4%)之间,同时进行皮肤自发荧光(SAF)测量以评估 AGEs。采用多变量逻辑回归模型和受试者工作特征曲线进行分析。该队列由 50.1%的女性组成,年龄为 57 [52;62] 岁,体重指数为 28.3 [25.4;31.6] kg/m2,糖尿病前期的患病率为 34.5%。与对照组相比,糖尿病前期患者的 SAF 更高(2.0 [1.7;2.2] vs. 1.9 [1.7;2.2],p < 0.001)。然而,HbA1c 与 SAF 水平无显著相关性(r = 0.026,p = 0.090)。此外,SAF 水平与糖尿病前期无独立相关性(OR = 1.12(0.96 至 1.30))。最后,SAF 没有一个好的截断值可以识别出糖尿病前期患者(AUC = 0.52(0.50 至 0.54),敏感性为 0.61,1 特异性为 0.56)。综上,虽然糖尿病前期患者的 SAF 水平升高,但在该人群中,结果的适用性和临床相关性较低。