Moreover, both advanced glycation expressed by higher skin autofluorescence or soluble receptor for AGEs (sRAGE) and impaired microvascular reactivity are involved in the pathogenesis of vascular complications in diabetes. Elevated SAF was recently associated with subclinical atherosclerosis in coronary and carotid arteries independently of conventional risk factors. Advanced glycation endproducts (AGEs) score measured at the fingertip in patients with cardiovascular disease have been associated with major adverse cardiovascular and cerebrovascular events. Higher risk of cardiovascular events related to SAF were already reported in three cohort studies, but they did not specifically address revascularization procedures. The higher rate of revascularizations among T2D patients with high SAF is well-accorded with its relationship to subclinical cardiovascular disease as reported by Chen. We suggest that its measurement may help to improve the performance of the screening before vascular explorations and revascularizations. The SAF has already been reported to predict cardiovascular events in three cohorts of people with diabetes. 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. 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. 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. 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.
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