Advanced glycation end products (AGE) are biomarkers for metabolic stress and can be detected in skin collagen non-invasively via skin intrinsic fluorescence techniques (SIF). AGE have been linked to complications in T1D and to mortality in both hemodialysis and type 2 diabetes patients. However, the relationship of SIF scores and mortality in T1D is unknown. This study examined the association of SIF scores to all-cause mortality in T1D. Participants were identified from the Pittsburgh Epidemiology of Diabetes and Complications study, a cohort of individuals diagnosed with childhood-onset T1D from 1950-80. SIF score was measured with the SCOUT DS® device in the year 2003-04 (baseline analytic year) in a convenience sample of 112 participants [mean years of age= 48.9 +/- (7.3), HbA1c=7.6% +/- (1.5), cumulative glycemic exposure over lifetime, or, A1c months=1095.9 +/- (495.2) diabetes duration in years=38.3 +/- (7.3)]. Vital status was assessed as of 12/10/2018, up to which 18 mortality events occurred. Univariately, compared to those who survived, the deceased had longer diabetes duration (p<0.001), higher A1c months (p<0.001), higher SIF scores (p<0.001), and were older (p<0.001). SIF score was significantly associated with mortality after adjusting for baseline diabetes duration; for each one unit increase in SIF score the odds of death increased by 18% (OR=1.18, 95% CI 1.03-1.34). A significant association persisted after adjustment for both baseline diabetes duration and A1c months (OR=1.17, 95% CI 1.02-1.34). These findings support the hypothesis that SIF scores are associated with mortality in T1D. The study sample is limited by sampling method, small size, lack of diversity, and possibly survivor bias. Given these limitations, further studies are required to confirm these findings.
E.L. Tomaszewski: None. T.J. Orchard: Consultant; Self; Boehringer Ingelheim International GmbH. M.S. Hawkins: None. T. Songer: Employee; Spouse/Partner; Boehringer Ingelheim Pharmaceuticals, Inc. J.D. Maynard: Consultant; Self; VisionQuest Biomedical LLC. Employee; Self; Avisa Pharma Inc. T. Costacou: None.
National Institutes of Health (DK34818); Rossi Memorial Fund