Endocrine Abstracts

Purpose

Obesity, diabetes mellitus, and metabolic syndrome (MetS) have been known to be associated with increased skin autofluorescence (SAF). In patients with MetS, higher SAF measurements were found to be associated with an increased number of the components of MetS. In this cross-sectional study, we aimed to evaluate the association of MetS and its’ components with skin autofluorescence in severely obese patients and to examine whether diabetes or metabolic syndrome contributed to the increase in skin AGE in obese patients.

Methods

We included 801 patients with morbid obesity who were followed up at Marmara University Medical School Endocrinology and Metabolism Department outpatient clinic between 2017 and 2020. Cross-sectionally, advanced glycation end products (AGEs) were measured using SAF in the forearm approximately 10 cm below the elbow fold, with an AGE Reader (DiagnOptics Technologies, Groningen, The Netherlands). Laboratory data [fasting plasma glucose, HbA1c, LDL-c, HDL-c, triglyceride, total cholesterol] were obtained retrospectively from the medical records.

Results

In this cross-sectional study, the prevalence of MetS in morbidly obese patients was 65.5% (n = 525). Diabetes mellitus and hypertension were present in 40.9% (n = 328) and 43.7% (n = 357) of the patients. Morbid obese patients and patients with MetS had higher SAF measurements compared to the control group, 1.85 ± 0.44 AU and 1.86 ± 0.43 AU versus 1.72 ± 0.30 AU, respectively (P = 0.016). SAF measurements of MetS negative patients were not statistically different from the control group (P = 0.076). Patients with five MetS criteria had higher SAF measurements compared to patients with less number of the MetS components (P = 0.019). There was no difference between SAF levels between diabetic patients, patients with impaired glucose metabolism and patients with normal glucose metabolism (P = 0.513). In multiple regression analysis, HDL level was found to be an independently associated parameter with SAF (R2 = 6.06%, P = 0.033).

Conclusion

We found that obesity itself rather than concurrent diabetes and metabolic syndrome contribute to an increase in SAF. Although MetS, diabetes mellitus are known as factors related to increased SAF, obesity can cause elevated SAF measurements in different ways independently of concomitant comorbid diseases, larger studies with longer follow-up are needed to enlighten the underlying mechanism.