Skin Autofluorescence May Contribute to Prediction of Low Bone Quality in Type 1 Diabetes—A Clinical Cross-Sectional Study

IF 6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-08-15 DOI:10.1002/dmrr.70080

Inge Agnete Gerlach Brandt, Peter Vestergaard, Morten Frost, Claus Bogh Juhl, Torben Harsløf

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Abstract

Introduction

People with type 1 diabetes are at risk of complications, including impaired bone health. Hyperglycaemia and accumulation of advanced glycation end products (AGEs) are involved in the development of those. Bone measurements such as trabecular bone score (TBS), high-resolution periphery quantitative computed tomography (HR-pQCT), and impact microindentation may detect impaired bone health better than bone mineral density (BMD). Clinical measures reflecting risk factors such as AGE accumulation or prevalence of cardiovascular autonomic neuropathy may also predict low bone quality.

Methods

This cross-sectional study included 111 adults with type 1 diabetes and 37 healthy sex- and age-matched. Bone health was assessed through DXA with TBS, HR-pQCT and impact microindentation. Accumulation of AGEs was evaluated by skin autofluorescence, and screening for cardiovascular autonomic neuropathy was performed.

Results

The mean (SD) age of the participants was 42.3 (13.8) years and the median (IQR) BMI was 26.9 [24.5; 30.1] kg/m². Median SkinAGE value was higher in the type 1 diabetes group (2.1 [1.9; 2.7]) than in the control group (1.8 [1.6; 2.3]), p = 0.004. In the diabetes group, SkinAGE correlated with femoral neck, total hip BMD, and TBS. SkinAGE showed predictive value for low TBS upon adjustment for age, sex, and BMI.

Conclusion

In persons with type 1 diabetes, higher levels of AGE accumulation measured by skin autofluorescence are related to a lower BMD as well as a lower TBS. Along with consideration of age, sex, BMI and other risk factors of osteoporosis, a high skin autofluorescence should increase the suspicion of impaired bone health.

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皮肤自身荧光可能有助于预测1型糖尿病患者的低骨质量——一项临床横断面研究

1型糖尿病患者有并发症的风险，包括骨骼健康受损。高血糖和晚期糖基化终产物（AGEs）的积累参与了这些疾病的发展。骨测量，如骨小梁评分（TBS）、高分辨率外围定量计算机断层扫描（HR-pQCT）和撞击微压痕，可能比骨矿物质密度（BMD）更好地检测骨骼健康受损。反映诸如AGE积累或心血管自主神经病变患病率等危险因素的临床指标也可以预测低骨质量。方法本横断面研究纳入111例成人1型糖尿病患者和37例性别和年龄相匹配的健康人群。通过DXA、TBS、HR-pQCT和冲击微压痕评估骨健康状况。通过皮肤自身荧光评估AGEs的积累，并进行心血管自主神经病变筛查。结果参与者的平均（SD）年龄为42.3岁（13.8岁），中位（IQR） BMI为26.9 [24.5；30.1 kg / m2。1型糖尿病组中位SkinAGE值较高(2.1 [1.9；2.7])高于对照组(1.8 [1.6；2.3]), p = 0.004。在糖尿病组中，SkinAGE与股骨颈、全髋关节骨密度和TBS相关。在调整年龄、性别和BMI后，SkinAGE显示出低TBS的预测价值。结论在1型糖尿病患者中，皮肤自身荧光测定的较高水平的AGE积累与较低的BMD和较低的TBS有关。考虑到年龄、性别、BMI等骨质疏松的危险因素，高皮肤自身荧光应该增加对骨骼健康受损的怀疑。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.