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Alkhami F, Borderie G, Foussard N, Larroumet A, Blanco L, Barbet-Massin MA, Ferriere A, Ducos C, Mohammedi K, Fawaz S, Couffinhal T, Rigalleau V. The skin autofluorescence may help to select patients with Type 2 diabetes candidates for screening to revascularization procedures. Cardiovasc Diabetol 2024; 23:32. [PMID: 38218857 PMCID: PMC10787440 DOI: 10.1186/s12933-024-02121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/02/2024] [Indexed: 01/15/2024] Open
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.
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Affiliation(s)
- Fadi Alkhami
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Gauthier Borderie
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Ninon Foussard
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Alice Larroumet
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Laurence Blanco
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Marie-Amélie Barbet-Massin
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Amandine Ferriere
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Claire Ducos
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Kamel Mohammedi
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Sami Fawaz
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Thierry Couffinhal
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France
| | - Vincent Rigalleau
- Endocrinology-Diabetology-Nutrition and Cardiology, Bordeaux CHU and University, 33000, Bordeaux, France.
- Endocrinology-Nutrition, CHU Bordeaux, Hospital Haut-Lévêque, Avenue de Magellan, 33604, Pessac, France.
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Chen VY, Siegfried LG, Tomic-Canic M, Stone RC, Pastar I. Cutaneous changes in diabetic patients: Primed for aberrant healing? Wound Repair Regen 2023; 31:700-712. [PMID: 37365017 PMCID: PMC10966665 DOI: 10.1111/wrr.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
Cutaneous manifestations affect most patients with diabetes mellitus, clinically presenting with numerous dermatologic diseases from xerosis to diabetic foot ulcers (DFUs). Skin conditions not only impose a significantly impaired quality of life on individuals with diabetes but also predispose patients to further complications. Knowledge of cutaneous biology and the wound healing process under diabetic conditions is largely limited to animal models, and studies focusing on biology of the human condition of DFUs remain limited. In this review, we discuss the critical molecular, cellular, and structural changes to the skin in the hyperglycaemic and insulin-resistant environment of diabetes with a focus specifically on human-derived data. Elucidating the breadth of the cutaneous manifestations coupled with effective diabetes management is important for improving patient quality of life and averting future complications including wound healing disorders.
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Affiliation(s)
- Vivien Y Chen
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lindsey G Siegfried
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Marjana Tomic-Canic
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rivka C Stone
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Irena Pastar
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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