Authors: Alpha M. Diallo, Stéphane Jaisson, Romain Barriquand, Céline Lukas, Sara Barraud, Bénédicte Decoudier, Maud Francois, Sang Ly, Rachid Mahmoudi, Carl Arndt, Pierre Nazeyrollas, Philippe Gillery & Brigitte Delemer
Abstract
Introduction
Type 1 diabetes is associated with an increased risk of vascular complications. We aimed to investigate the association between serum and tissue advanced glycation end-products (AGEs) and micro- and macrovascular complications in type 1 diabetes (T1D).
Methods
We conducted a cross-sectional study on 196 adults with T1D (mean age 44.53 ± 16, mean duration of diabetes 22 ± 12 years, mean HbA1c 8 ± 1.2%). AGEs were measured in blood serum (i.e., carboxymethyllysine (CML), methylglyoxal-hydroimidazolone-1 (MGH1), and pentosidine) and by measurement of skin autofluorescence (SAF). Associations between AGEs levels and vascular complications were analyzed using binary logistic regression. Correlations between AGEs and pulse wave velocity (PWV) were also assessed by linear regressions. Significant differences were set for p values less than 0.05.
Results
We found positive associations between different AGEs and vascular complications. SAF was associated with both microangiopathy (retinopathy: OR = 1.92, p = 0.011; neuropathy: OR = 2.02, p = 0.04; any microangiopathy: OR = 2.83, p < 0.0001) and macroangiopathy (coronaropathy: OR = 3.11, p = 0.009; any macroangiopathy: OR = 2.78, p = 0.003). For circulating AGEs, pentosidine was significantly associated with coronaropathy (OR = 1.61, p = 0.01) and any macroangiopathy (OR = 1.52, p = 0.005) while MGH1 was associated with nephropathy (OR 1.72, p = 0.03). Furthermore, a significant linear correlation was found between PWV and SAF (r = 0.43, p < 0.001), pentosidine (r = 0.28, p < 0.001), and MGH1 (r = 0.16, p = 0.031), but not for CML (r = 0.03, p = 0.598).
Conclusions
Skin autofluorescence appears to be a useful marker for investigating both micro- and macrovascular complications in T1D. In this study, pentosidine was associated with macroangiopathy and MGH1 with nephropathy among the circulating AGEs. Furthermore, the correlations between PWV and AGEs may suggest their value in early prediction of vascular complications in T1D.
Key Summary Points |
Type 1 diabetes (T1D) is marked by debilitating degenerative complications on the long run due to chronic hyperglycemia. |
Advanced glycation end-products seem to play a key role as potential biomarkers of vascular complications in diabetes. |
We explored in a cross-sectional study the association between the circulating (i.e., carboxymethyllysine (CML), pentosidine, methylglyoxal–hydroimidazolone-1 (MGH1)) and tissue (i.e., skin autofluorescence (SAF)) advanced glycation end–products (AGEs) and the micro and macro vascular complications in 196 patients with T1D. |
SAF and circulating AGEs display significant associations with micro and macrovascular complications in T1D. |
SAF and circulating AGEs have potential therapeutic implications in T1D by identifying sub-populations of T1D requiring more aggressive treatment and monitoring to prevent vascular events. |