Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis

Background: Advanced glycation end products (AGE), one of the main factors causing diabetic end-organ damage, accumulate in long half-life proteins, such as skin and cartilage collagen. AGE measurement may offer additional evidence to predict diabetic vascular complications. Skin autofluorescence (S...

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Autores principales:	Mahboobeh sadat Hosseini, MD, Zahra Razavi, MD, Amir Houshang Ehsani, MD, Alireza Firooz, MD, Siamack Afazeli, Pharm.D.
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Diabetes Mellitus Skin autofluorescence Advanced glycation end product Diabetic microvascular complication Diabetic macrovascular complication Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/ebe408a0a053445ba8550a94ccf455b4
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spelling	oai:doaj.org-article:ebe408a0a053445ba8550a94ccf455b42021-11-18T04:51:16ZClinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis2589-537010.1016/j.eclinm.2021.101194https://doaj.org/article/ebe408a0a053445ba8550a94ccf455b42021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589537021004752https://doaj.org/toc/2589-5370Background: Advanced glycation end products (AGE), one of the main factors causing diabetic end-organ damage, accumulate in long half-life proteins, such as skin and cartilage collagen. AGE measurement may offer additional evidence to predict diabetic vascular complications. Skin autofluorescence (SAF) is suggested as a non-invasive, quick, and reliable method to measure tissue AGE level. The aim of this study was to review and evaluate evidence on the clinical validation of SAF measurement in diabetes mellitus (DM) patients. Methods: In this systematic review and meta-analysis, we searched ''PubMed'' (MEDLINE) and ''Cochrane'' databases from their inception to 10 August 2021 for observational studies concerning SAF measurement in diabetic patients. The following key terms were used in advanced searching: “Diabetes”, “Diabetes Mellitus”,” DM”, “Glycation “, “Advanced Glycation End product”, “AGE”, “skin autofluorescence”, “SAF”. Published studies that included DM patients and estimated their AGE using SAF were considered eligible for meta-analysis. Articles that were editorials, study proposals, congress posters, or case reports and were not on human subjects were excluded. We used a random-effect models for meta-analyzing the clinical validation of SAF in DM with particular emphasis on chronic diabetes complications. Findings: We identified 881 records and twenty-nine records fulfilled our eligibility criteria and were included in the systematic review and meta-analysis. A statistically significant correlation was found between SAF and diabetes last HbA1c 0.21(0.13,0.28) in studies with substantial heterogeneity (I2=77.99%, p<0.05). Nevertheless, a significant positive association between SAF level and diabetic retinopathy (DR) [(OR= 1.05, 95% CI=1.03,1.08), (I2=63.78%, p<0.05)], diabetic peripheral neuropathy (DPN) [(OR= 1.11, 95%CI= 1.06,1.16), (I2=79.17%, p<0.05)], diabetic nephropathy (DNP) [(OR= 1.08, 95%CI: 1.05,1.11), (I2=65.36%, p<0.05)] and diabetic macrovascular events (D-MVE) [(OR=1.08, 95%CI=1.05,1.11) (I2=67.32, p<0.05)] were found. Interpretation: Our study confirmed the significance of SAF measurement as a non-invasive surrogate marker of DM micro and macrovascular complications. Skin AGE estimation may be a useful factor for the prediction and early detection of irreversible DM complications. More studies with larger populations and longer follow-up periods are required.Mahboobeh sadat Hosseini, MDZahra Razavi, MDAmir Houshang Ehsani, MDAlireza Firooz, MDSiamack Afazeli, Pharm.D.ElsevierarticleDiabetes MellitusSkin autofluorescenceAdvanced glycation end productDiabetic microvascular complicationDiabetic macrovascular complicationMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101194- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diabetes Mellitus Skin autofluorescence Advanced glycation end product Diabetic microvascular complication Diabetic macrovascular complication Medicine (General) R5-920
spellingShingle	Diabetes Mellitus Skin autofluorescence Advanced glycation end product Diabetic microvascular complication Diabetic macrovascular complication Medicine (General) R5-920 Mahboobeh sadat Hosseini, MD Zahra Razavi, MD Amir Houshang Ehsani, MD Alireza Firooz, MD Siamack Afazeli, Pharm.D. Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis
description	Background: Advanced glycation end products (AGE), one of the main factors causing diabetic end-organ damage, accumulate in long half-life proteins, such as skin and cartilage collagen. AGE measurement may offer additional evidence to predict diabetic vascular complications. Skin autofluorescence (SAF) is suggested as a non-invasive, quick, and reliable method to measure tissue AGE level. The aim of this study was to review and evaluate evidence on the clinical validation of SAF measurement in diabetes mellitus (DM) patients. Methods: In this systematic review and meta-analysis, we searched ''PubMed'' (MEDLINE) and ''Cochrane'' databases from their inception to 10 August 2021 for observational studies concerning SAF measurement in diabetic patients. The following key terms were used in advanced searching: “Diabetes”, “Diabetes Mellitus”,” DM”, “Glycation “, “Advanced Glycation End product”, “AGE”, “skin autofluorescence”, “SAF”. Published studies that included DM patients and estimated their AGE using SAF were considered eligible for meta-analysis. Articles that were editorials, study proposals, congress posters, or case reports and were not on human subjects were excluded. We used a random-effect models for meta-analyzing the clinical validation of SAF in DM with particular emphasis on chronic diabetes complications. Findings: We identified 881 records and twenty-nine records fulfilled our eligibility criteria and were included in the systematic review and meta-analysis. A statistically significant correlation was found between SAF and diabetes last HbA1c 0.21(0.13,0.28) in studies with substantial heterogeneity (I2=77.99%, p<0.05). Nevertheless, a significant positive association between SAF level and diabetic retinopathy (DR) [(OR= 1.05, 95% CI=1.03,1.08), (I2=63.78%, p<0.05)], diabetic peripheral neuropathy (DPN) [(OR= 1.11, 95%CI= 1.06,1.16), (I2=79.17%, p<0.05)], diabetic nephropathy (DNP) [(OR= 1.08, 95%CI: 1.05,1.11), (I2=65.36%, p<0.05)] and diabetic macrovascular events (D-MVE) [(OR=1.08, 95%CI=1.05,1.11) (I2=67.32, p<0.05)] were found. Interpretation: Our study confirmed the significance of SAF measurement as a non-invasive surrogate marker of DM micro and macrovascular complications. Skin AGE estimation may be a useful factor for the prediction and early detection of irreversible DM complications. More studies with larger populations and longer follow-up periods are required.
format	article
author	Mahboobeh sadat Hosseini, MD Zahra Razavi, MD Amir Houshang Ehsani, MD Alireza Firooz, MD Siamack Afazeli, Pharm.D.
author_facet	Mahboobeh sadat Hosseini, MD Zahra Razavi, MD Amir Houshang Ehsani, MD Alireza Firooz, MD Siamack Afazeli, Pharm.D.
author_sort	Mahboobeh sadat Hosseini, MD
title	Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis
title_short	Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis
title_full	Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis
title_fullStr	Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis
title_full_unstemmed	Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis
title_sort	clinical significance of non-invasive skin autofluorescence measurement in patients with diabetes: a systematic review and meta-analysis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/ebe408a0a053445ba8550a94ccf455b4
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Clinical Significance of Non-invasive Skin Autofluorescence Measurement in Patients with Diabetes: A Systematic Review and Meta-analysis

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