Skin Autofluorescence as a Potential Adjunctive Marker for Cardiovascular Risk Assessment in Type 2 Diabetes: A Systematic Review

Author:

Reurean-Pintilei Delia123ORCID,Pantea Stoian Anca4ORCID,Potcovaru Claudia-Gabriela5ORCID,Salmen Teodor6ORCID,Cinteză Delia5ORCID,Stoica Roxana-Adriana6,Lazăr Sandra278,Timar Bogdan2910

Affiliation:

1. Doctoral School of Medicine and Pharmacy, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania

2. Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania

3. Department of Diabetes, Nutrition and Metabolic Diseases, Consultmed Medical Centre, 700544 Iasi, Romania

4. Diabetes, Nutrition and Metabolic Diseases Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania

5. 9th Department of Physical Medicine and Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania

6. Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania

7. First Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania

8. Department of Hematology, Emergency Municipal Hospital Timisoara, 300041 Timisoara, Romania

9. Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania

10. Department of Diabetes, Nutrition and Metabolic Diseases, “Pius Brinzeu” Emergency Hospital, 300723 Timisoara, Romania

Abstract

Diabetes mellitus (DM), due to its long-term hyperglycemia, leads to the accumulation of advanced glycation end-products (AGEs), especially in the vessel walls. Skin autofluorescence (SAF) is a non-invasive tool that measures AGEs. DM patients have a rich dietary source in AGEs, associated with high oxidative stress and long-term inflammation. AGEs represent a cardiovascular (CV) risk factor, and they are linked with CV events. Our objective was to assess whether SAF predicts future CV events (CVE) by examining its association with other CV risk factors in patients with type 2 DM (T2DM). Additionally, we assessed the strengths and limitations of SAF as a predictive tool for CVE. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, we conducted a systematic review with CRD42024507397 protocol, focused on AGEs, T2DM, SAF, and CV risk. We identified seven studies from 2014 to 2024 that predominantly used the AGE Reader Diagnostic Optic tool. The collective number of patients involved is 8934, with an average age of 63. So, SAF is a valuable, non-invasive marker for evaluating CV risk in T2DM patients. It stands out as a CV risk factor associated independently with CVE. SAF levels are influenced by prolonged hyperglycemia, lifestyle, aging, and other chronic diseases such as depression, and it can be used as a predictive tool for CVE.

Publisher

MDPI AG

Reference78 articles.

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