PMID- 27906877
OWN - NLM
STAT- MEDLINE
DCOM- 20170407
LR  - 20171116
VI  - 126
IP  - 11
DP  - 2016 Nov 22
TI  - Association between small fiber neuropathy and higher skin accumulation of 
      advanced glycation end products in patients with type 1 diabetes.
PG  - 847-853
LID - 10.20452/pamw.3649 [doi]
AB  - INTRODUCTION Advanced glycation end products (AGEs) play a crucial role in the 
      pathogenesis of diabetic peripheral neuropathy (DPN). OBJECTIVES The aim of the 
      study was to assess the skin accumulation of AGEs in patients with long‑lasting 
      type 1 diabetes in relation to the presence of DPN. PATIENTS AND METHODS We 
      evaluated 178 patients with type 1 diabetes (99 men; age, 43 years [interquartile 
      range [IQR], 34-54 years]; disease duration, 25 years [IQR, 18-31 years]). DPN 
      was diagnosed if 2 or more of the following 5 abnormalities were present: 
      symptoms of neuropathy, lack of ankle reflexes, and impaired sensation of touch, 
      temperature, and/or vibration. PGP 9.5‑immunoreactive nerve fibers were counted 
      to assess intraepidermal nerve fiber density (IENFD) in skin biopsy. The 
      accumulation of AGEs in the skin was assessed on the basis of skin 
      autofluorescence (AF).  RESULTS Patients with DPN (45%), compared with those 
      without neuropathy, had higher skin AF (2.6 AU [IQR, 2.3-3.1 AU] vs 2.1 AU [IQR, 
      1.8-2.5 AU]; P <0.001) and lower IENFD (10 fibers/mm [IQR, 7-14 fibers/mm] vs 12 
      fibers/mm [IQR, 8-16 fibers/mm]; P = 0.005). We found a positive correlation 
      between skin AF and patients' age (Rs = 0.44; P <0.001), diabetes duration (Rs = 
      0.32; P <0.001), and a negative correlation between skin AF and the estimated 
      glomerular filtration rate (Rs = -0.26, P <0.001) and IENFD (Rs = -0.22; P = 
      0.004). In a multiple linear regression analysis, skin AF was independently 
      associated with age (beta = 0.45; P <0.001), glycated hemoglobin level (beta = 0.19; P 
      = 0.007), and IENFD (beta = - 0.14; P = 0.04) (R2 = 0.27; P <0.001). In multivariate 
      logistic regression, the presence of DPN was independently associated with skin 
      AF (odds ratio, 4.16; 95% confidence interval, 1.88-9.20; P <0.001). CONCLUSIONS 
      The presence of DPN, and particularly small fiber neuropathy, is associated with 
      a higher accumulation of AGEs in the skin of patients with type 1 diabetes.
FAU - Araszkiewicz, Aleksandra
AU  - Araszkiewicz A
FAU - Gandecka, Agnieszka
AU  - Gandecka A
FAU - Nowicki, Michal
AU  - Nowicki M
FAU - Uruska, Aleksandra
AU  - Uruska A
FAU - Malinska, Agnieszka
AU  - Malinska A
FAU - Kowalska, Katarzyna
AU  - Kowalska K
FAU - Wierusz-Wysocka, Bogna
AU  - Wierusz-Wysocka B
FAU - Zozulinska-Ziolkiewicz, Dorota
AU  - Zozulinska-Ziolkiewicz D
LA  - eng
PT  - Journal Article
DEP - 20161122
PL  - Poland
TA  - Pol Arch Med Wewn
JT  - Polskie Archiwum Medycyny Wewnetrznej
JID - 0401225
RN  - 0 (Glycation End Products, Advanced)
SB  - IM
MH  - Adult
MH  - Biopsy
MH  - Diabetes Mellitus, Type 1/*complications/pathology
MH  - Glycation End Products, Advanced/*analysis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nerve Fibers/*pathology
MH  - Skin/*chemistry/pathology
MH  - Small Fiber Neuropathy/*etiology/pathology
EDAT- 2016/12/03 06:00
MHDA- 2017/04/08 06:00
CRDT- 2016/12/02 06:00
PHST- 2016/12/02 06:00 [entrez]
PHST- 2016/12/03 06:00 [pubmed]
PHST- 2017/04/08 06:00 [medline]
AID - 10.20452/pamw.3649 [doi]
PST - ppublish
SO  - Pol Arch Med Wewn. 2016 Nov 22;126(11):847-853. doi: 10.20452/pamw.3649. Epub 
      2016 Nov 22.