Background: Chronic accumulation of advanced glycation end products (AGEs) has been suggested as predictor of cardiovascular complications in diabetes mellitus. Tissue AGEs can be measured noninvasively and reproducibly in the skin by Skin autofluorescence (SAF), a clinical tool developed in the 2000s. This study aimed to estimate the relationship between AGEs indicated by SAF levels and the risk of micro- and macro-vascular complications based on data from observational studies.

Methods: A systematic literature search was performed using PubMed, Embase, and the Web of Science databases from their inceptions until December 2018. Two reviewers identified eligible studies that reported the measure of AGEs by SAF in patients with diabetes mellitus. Meta-analyses using random effects models were used to analyze the data.

Results: Twenty-four published studies involving 2715 patients with diabetes (1756 T2D and 959 T1D), 1673 controls with uncomplicated diabetes and 1283 healthy controls were included in the meta‐analysis. Five diabetes-related microvascular complications: Nephropathy, Neuropathy, Retinopathy, Erectile dysfunction and Diabetic foot ulcer and 3 main macrovascular complications : Peripheral arterial diseases, Stroke and CVD were identified. Both, in patients with T1D or T2D, SAF levels were significantly higher compared to healthy controls with substantial heterogeneity (I2=78% in T1D and I2=91% in T2D; P<0.0001). Interestingly, patients with complicated diabetes exhibited significantly higher SAF levels compared to patients with uncomplicated diabetes: for T2D: mean difference [MD]: 0.303 AU; 95% CI: 0.237-0.369) with mild heterogeneity (I2=20%; P<0.0001). For T1D: MD: 0.385AU; 95% CI: 0.289-0.480), with moderate heterogeneity (I2=54%; P<0.0001).

Conclusions: Our findings suggest that SAF measure may play an important role as a biomarker for patients with high risk of diabetes-related vascular complications.


Y. Kouidrat: None.

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