Bueno Jorys, Diallo Alpha M, Jaisson Stéphane, Fontaine Jenny, Lukas Céline, Barriquand Romain, Vitellius Géraldine, Gillery Philippe, Delemer Brigitte, Barraud Sara
Service d'Endocrinologie Diabète Nutrition, Reims, France.
Service d'Endocrinologie Diabète Nutrition, Reims, France; VIEFRA EA 3797, URCA, UFR Médecine, Pôle Recherche et Santé Publique, CHU de Reims, Avenue du Général Koenig 51092, Reims, France.
Diabetes Metab. 2025 Sep;51(5):101682. doi: 10.1016/j.diabet.2025.101682. Epub 2025 Jun 23.
Advanced glycation end-products (AGEs) are known to play a role in the pathophysiology of type 1 diabetes (T1D) complications. The aim of this study was to assess the predictive value of AGEs indirectly evaluated by skin auto-fluorescence (SAF) on the occurrence of cardiovascular events (CVEs) in T1D.
We measured baseline SAF in T1D patients with at least 10 years history of diabetes and assessed incident CVEs. An optimum threshold of SAF was determined using ROC curve, and its predictive value was assessed by Cox proportional regression.
The study included 179 patients, 53 % of whom were women. At baseline, the mean age was 47.7 ± 15.9 years, the mean duration of diabetes was 26.4 ± 12.2 years. Median HbA was 7.7 % (7.3-8.7) and median LDL cholesterol was 2.58 mmol/l (2.14-3.07). Median follow-up was 7.4 years (6.85 - 7.7) with 34 CVEs in 24 patients. The median SAF level was 2.7 (2.3-3.1) in patients with incident CVEs and 2.1 (1.8-2.6) in patients without CVEs. The optimum threshold of SAF to differentiate patients with or without incident CVEs was 2.2. The occurrence of CVE was predicted by the optimum SAF threshold in the unadjusted model (HR 6.46), but also after adjustment with different models (HR 3.15-5.05).
SAF level is higher in people living with T1D who will present CVEs. Furthermore, SAF threshold of 2.2 predicted the occurrence of CVE. If these results are confirmed, SAF could be a useful marker in cardiovascular risk stratification in T1D.
已知晚期糖基化终产物（AGEs）在1型糖尿病（T1D）并发症的病理生理学中起作用。本研究的目的是评估通过皮肤自发荧光（SAF）间接评估的AGEs对T1D患者心血管事件（CVE）发生的预测价值。
我们测量了糖尿病病史至少10年的T1D患者的基线SAF，并评估了CVE的发生率。使用ROC曲线确定SAF的最佳阈值，并通过Cox比例回归评估其预测价值。
该研究纳入了179名患者，其中53%为女性。基线时，平均年龄为47.7±15.9岁，平均糖尿病病程为26.4±12.2年。HbA中位数为7.7%（7.3-8.7），低密度脂蛋白胆固醇中位数为2.58 mmol/l（2.14-3.07）。中位随访时间为7.4年（6.85-7.7），24名患者发生了34次CVE。发生CVE的患者SAF中位数为2.7（2.3-3.1），未发生CVE的患者为2.1（1.8-2.6）。区分发生或未发生CVE患者的SAF最佳阈值为2.2。在未调整模型中，最佳SAF阈值可预测CVE的发生（HR 6.46），在不同模型调整后也是如此（HR 3.15-5.05）。
发生CVE的T1D患者的SAF水平更高。此外，SAF阈值2.2可预测CVE的发生。如果这些结果得到证实，SAF可能是T1D心血管风险分层中的一个有用标志物。
