Scripties UMCG - Rijksuniversiteit Groningen
 
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Follow up of Advanced Glycation End products in Children and Adolescents with Type I Diabetes Mellitus : FACADE

(2018) Heutink, W.P.

Background:
Advanced glycation endproducts (AGEs) have a major contribution in the development of
micro- and macrovascular disease in children with type 1 diabetes mellitus (T1DM). AGEs
can be measured non-invasively with skin autofluorescence (sAF). Predicting the risk on
developing diabetic complications in children with T1DM is very important. The primary aim
was to monitor the sAF value progression and to evaluate the predictive value of sAF level on
the development of micro- and macrovascular disease in children with T1DM.
Methods:
In children with T1DM, the first sAF measurement was performed between September 2013
and Oktober 2014. The follow-up sAF measurement was performed between March 2016 and
May 2018. Anthropometric and laboratory data were extracted from medical charts. sAF level
progression was evaluated using a paired t-test, the predictive value of sAF level on the
development of complications was studied using student’s t-tests and correlations between
sAF values and HbA1c and other related variables were studied using Pearson’s correlation
coefficient. Multivariable linear regression analysis was used to evaluate the effect of
different study parameters on sAF values.
Results:
81 children were included with a mean age of 9.8 ± 3.0, a mean disease duration of 34.5 ±
33.5 months and a mean follow-up period of 46.8 ± 7.2 months. Baseline sAF values
increased significantly from 1.24 ± 0.26 AU at baseline to 1.38 ± 0.30 AU at follow-up (p <
0.01). Patients who developed retinopathy (n=3) had higher sAF values than children who did
not develop retinopathy (n=50) both at baseline (1.23 ± 0.25 vs. 1.53 ± 0.61) and at follow-up
(1.36 ± 0.32 vs. 1.67 ± 0.15). sAF values positively correlated with average HbA1c the year
prior to the measurement (r=0.50), average HbA1c over the entire follow-up period (r=0.57),
age (r=0.36), disease duration (r=0.32) and serum triglycerides (r = 0.39).
Conclusion:
sAF measurement reflects long-term glycaemic control, considering a stronger correlation
with the HbA1c over the entire follow-up period. Therefore the predictive value of sAF
measurement on the development of micro- and macrovascular complications in children with
T1DM is promising. However, longitudinal follow-up studies, measuring sAF values and
monitoring diabetic complications should be performed.






 
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