Skin autofluorescence predicts cancer in subjects with type 2 diabetes

Introduction Subjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by mea...

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Main Authors: Laurence Baillet-Blanco, Vincent Rigalleau, Kamel Mohammedi, Ninon Foussard, Alice Larroumet, Marine Rigo, Pauline Poupon, Marie Monlun, Maxime Lecocq, Anne-Claire Devouge, Claire Ducos, Marion Liebart, Quentin Battaglini
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/9/1/e001312.full
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author Laurence Baillet-Blanco
Vincent Rigalleau
Kamel Mohammedi
Ninon Foussard
Alice Larroumet
Marine Rigo
Pauline Poupon
Marie Monlun
Maxime Lecocq
Anne-Claire Devouge
Claire Ducos
Marion Liebart
Quentin Battaglini
author_facet Laurence Baillet-Blanco
Vincent Rigalleau
Kamel Mohammedi
Ninon Foussard
Alice Larroumet
Marine Rigo
Pauline Poupon
Marie Monlun
Maxime Lecocq
Anne-Claire Devouge
Claire Ducos
Marion Liebart
Quentin Battaglini
author_sort Laurence Baillet-Blanco
collection DOAJ
description Introduction Subjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by measuring the skin autofluorescence. We searched whether the skin autofluorescence could predict new cancers in persons with type 2 diabetes.Research design and methods From 2009 to 2015, we measured the skin autofluorescence of 413 subjects hospitalized for uncontrolled or complicated type 2 diabetes, without any history of cancer. The participants were followed for at least 1 year and the occurrences of new cancers were compared according to their initial skin autofluorescences.Results The participants were mainly men (57.9%), with poorly controlled (HbA1c 72±14 mmol/mol or 8.7%±1.8%) and/or complicated type 2 diabetes. Their median skin autofluorescence was 2.6 (2.2–3.0) arbitrary units. Forty-five new cancer cases (10.9%) were registered during 4.8±2.3 years of follow-up: 75.6% of these subjects had skin autofluorescence higher than the median (χ2: p=0.001). By Cox regression analysis adjusted for age, gender, body mass index, history of smoking and renal parameters, skin autofluorescence >2.6 predicted a 2.57-fold higher risk of cancer (95% CI 1.28 to 5.19, p=0.008). This association remained significant after excluding the eight cancers that occurred in the 4 years after inclusion (OR 2.95, 95% CI 1.36 to 6.38, p=0.006). As a continuous variable, skin autofluorescence was also related to new cancers (OR 1.05, 95% CI 1.01 to 1.10, p=0.045).Conclusions Skin autofluorescence, a potential marker of glycemic memory, predicts the occurrence of cancer in subjects with type 2 diabetes. This relation provides a new clinical argument for the role of AGEs in cancer. Their estimation by measuring the skin autofluorescence may help select subjects with diabetes in cancer screening programs.
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spelling doaj-art-1a742e76ed424b998d8475731a2a7b712024-12-12T14:35:13ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2020-001312Skin autofluorescence predicts cancer in subjects with type 2 diabetesLaurence Baillet-Blanco0Vincent Rigalleau1Kamel Mohammedi2Ninon Foussard3Alice Larroumet4Marine Rigo5Pauline Poupon6Marie Monlun7Maxime Lecocq8Anne-Claire Devouge9Claire Ducos10Marion Liebart11Quentin Battaglini12Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceDepartment of Endocrinology and Diabetology, Haut-Lévêque University Hospital, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceNutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, FranceIntroduction Subjects with type 2 diabetes have an excess risk of cancer. The potential role of advanced glycation end products (AGEs) accumulated during long-term hyperglycemia in cancer development has been suggested by biological studies but clinical data are missing. AGEs can be estimated by measuring the skin autofluorescence. We searched whether the skin autofluorescence could predict new cancers in persons with type 2 diabetes.Research design and methods From 2009 to 2015, we measured the skin autofluorescence of 413 subjects hospitalized for uncontrolled or complicated type 2 diabetes, without any history of cancer. The participants were followed for at least 1 year and the occurrences of new cancers were compared according to their initial skin autofluorescences.Results The participants were mainly men (57.9%), with poorly controlled (HbA1c 72±14 mmol/mol or 8.7%±1.8%) and/or complicated type 2 diabetes. Their median skin autofluorescence was 2.6 (2.2–3.0) arbitrary units. Forty-five new cancer cases (10.9%) were registered during 4.8±2.3 years of follow-up: 75.6% of these subjects had skin autofluorescence higher than the median (χ2: p=0.001). By Cox regression analysis adjusted for age, gender, body mass index, history of smoking and renal parameters, skin autofluorescence >2.6 predicted a 2.57-fold higher risk of cancer (95% CI 1.28 to 5.19, p=0.008). This association remained significant after excluding the eight cancers that occurred in the 4 years after inclusion (OR 2.95, 95% CI 1.36 to 6.38, p=0.006). As a continuous variable, skin autofluorescence was also related to new cancers (OR 1.05, 95% CI 1.01 to 1.10, p=0.045).Conclusions Skin autofluorescence, a potential marker of glycemic memory, predicts the occurrence of cancer in subjects with type 2 diabetes. This relation provides a new clinical argument for the role of AGEs in cancer. Their estimation by measuring the skin autofluorescence may help select subjects with diabetes in cancer screening programs.https://drc.bmj.com/content/9/1/e001312.full
spellingShingle Laurence Baillet-Blanco
Vincent Rigalleau
Kamel Mohammedi
Ninon Foussard
Alice Larroumet
Marine Rigo
Pauline Poupon
Marie Monlun
Maxime Lecocq
Anne-Claire Devouge
Claire Ducos
Marion Liebart
Quentin Battaglini
Skin autofluorescence predicts cancer in subjects with type 2 diabetes
BMJ Open Diabetes Research & Care
title Skin autofluorescence predicts cancer in subjects with type 2 diabetes
title_full Skin autofluorescence predicts cancer in subjects with type 2 diabetes
title_fullStr Skin autofluorescence predicts cancer in subjects with type 2 diabetes
title_full_unstemmed Skin autofluorescence predicts cancer in subjects with type 2 diabetes
title_short Skin autofluorescence predicts cancer in subjects with type 2 diabetes
title_sort skin autofluorescence predicts cancer in subjects with type 2 diabetes
url https://drc.bmj.com/content/9/1/e001312.full
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