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Updated: Aug 14, 2026
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
The skin autofluorescence may help to select patients with Type 2 diabetes candidates for screening to
Fadi Alkhami1, Gauthier Borderie1, Ninon Foussard1
1Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France.
Insights
Skin autofluorescence (SAF) predicts vascular events in Type 2 Diabetes patients. Higher SAF levels indicate increased risk for arterial revascularizations, aiding in identifying individuals needing further cardiovascular screening.
Area of Science:
- Biomedical Engineering
- Clinical Medicine
- Cardiovascular Research
Background:
- Advanced Glycation End-products (AGEs) accumulate in tissues with aging and diabetes.
- Skin autofluorescence (SAF) is a non-invasive biomarker for AGE accumulation.
- Subclinical cardiovascular disease is prevalent in diabetes and often underestimated by traditional risk factors.
Abstract:
Chen et al. recently related the skin autofluorescence (SAF) of Advanced Glycation End-products to subclinical cardiovascular disease in the 3001 participants from the general population (Rotterdam study), with a particularly close relationship for the 413 subjects with diabetes. Because conventional vascular risk factors do not capture the risk in diabetes very well, this relationship may help to select high-risk individuals for the screening of silent myocardial ischemia, which has yet to prove its benefit in randomized controlled trials. Among 477 patients with uncontrolled and/or complicated Type 2 Diabetes, we measured the SAF ten years ago, and we registered new revascularizations during a 54-months follow-up. The patients with SAF > 2.6 Arbitrary units (AUs), the median population value, experienced more revascularizations of the coronary (17/24) and lower-limb arteries (13/17) than patients with a lower SAF, adjusted for age, sex, diabetes duration, vascular complications, and smoking habits: HR 2.17 (95% CI: 1.05-4.48), p = 0.035. The SAF has already been reported to predict cardiovascular events in three cohorts of people with diabetes. We suggest that its measurement may help to improve the performance of the screening before vascular explorations and revascularizations.
