Association of Skin Intrinsic Fluorescence with Retinal Microvascular Complications of Long Term Type 1 Diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy

ABSTRACT

Objective: To determine the association between skin intrinsic fluorescence (SIF), a noninvasive measure of advanced glycation endproducts and oxidative stress in skin, and retinal microvascular complications of long duration type 1 diabetes, proliferative diabetic retinopathy (PDR) and macular edema.

Methods: A cross-sectional cohort study of persons with type 1 diabetes in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) who participated in a 32-year follow-up examination in 2012–2014. Subjects underwent a physical examination, answered a health questionnaire, and had fundus photographs taken. SIF was measured on the underside of the left forearm near the elbow with the SCOUT DS^® skin fluorescence spectrometer. Two representative SIF measures were used for these analyses: SIF01 excited by an LED centered at 375 nm with correction factors K_x = 0.6 and K_m = 0.2 and SIF15 excited by an LED centered at 456 nm with correction factors K_x = 0.4 and K_m = 0.9.

Results: The 414 participants had mean diabetes duration of 42.2 years (standard deviation 6.8 years, range 32.9–67.9 years). PDR was statistically significantly associated (p < 0.05) with both SIF measures in multivariate models including other relevant factors (odds ratio [OR] = 1.17 for SIF01 and 1.20 for SIF15).

Conclusion: Skin intrinsic fluorescence measures are independently associated with PDR in the WESDR. Incidence information is needed to evaluate whether there is a causal relationship.

KEYWORDS:

• Advanced glycation endproducts
• macular edema
• nephropathy
• proliferative diabetic retinopathy
• skin intrinsic fluorescence

Acknowledgments

A poster of this study was presented during the 2016 ARVO Annual Meeting, May 1–5, 2016, in Seattle, Washington, USA.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

Funding

This study was supported by grant EY016379 (to B.K., R.K.) and a Research Vision Core grant (EY016665) from the National Institutes of Health, Bethesda, MD, and an unrestricted grant from Research to Prevent Blindness, New York, NY. The sponsor or funding organization had no role in the design or conduct of this research.

The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Eye Institute, the National Institute of Biomedical Imaging and Bioengineering or the National Institutes of Health.

Additional information

Funding

This study was supported by grant EY016379 (to B.K., R.K.) and a Research Vision Core grant (EY016665) from the National Institutes of Health, Bethesda, MD, and an unrestricted grant from Research to Prevent Blindness, New York, NY. The sponsor or funding organization had no role in the design or conduct of this research. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Eye Institute, the National Institute of Biomedical Imaging and Bioengineering or the National Institutes of Health.