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Diabetes

29 December 2018

Skin 'glow' test might someday spot disease risk early

A skin light test called 'autofluorescence' can be used as a first screening method to predict type 2 diabetes, cardiovascular disease and mortality.

A test that measures wavelengths of light coming off skin cells might detect type 2 diabetes, heart disease and even your risk of dying, new research shows.

It's possible that – someday – a quick "autofluorescence" light test to the skin might be used by consumers in "supermarkets, pharmacies or drugstores as a first estimate of [health] risk", according to a Dutch research team.

Natural byproducts of illness

The new device is called an AGE Reader, with AGE standing for chemicals found on skin cells called "advanced glycation end-products".

AGEs are natural byproducts of illness that can – using the AGE Reader – glow or "fluoresce" on the skin, explained the researchers led by Bruce Wolffenbuttel of the University of Groningen.

Their new study tested the device on the skin of nearly 73 000 people whose health was then tracked up to 10 years, with an average follow-up of four years.

During the follow-up period, more than 1 000 participants went on to develop type 2 diabetes, close to 1 300 developed heart disease and 928 died.

A 1-unit rise in skin autofluorescence using the AGE Reader "was associated with a threefold increase in risk of type 2 diabetes or cardiovascular disease, and a five-times increased risk of death", the researchers reported in November in the journal Diabetologia.

Supported by new findings

What's more, the device's power at predicting death or disease remained steady even when telltale risk factors – such as obesity, high blood pressure, high cholesterol or poor blood sugar control – were absent, the study found.

Even after adjusting for those risk factors, a 1-unit rise in the AGE Reader autofluorescence score was tied to a 26% rise in risk for type 2 diabetes; a 33% rise in heart disease risk; and a near-doubling of the odds for death during the follow-up period.

The bottom line is that the new findings support skin autofluorescence "as a first screening method to predict type 2 diabetes, cardiovascular disease and mortality", the researchers said in a journal news release.

One US diabetes specialist was intrigued by the research.

Dr Gerald Bernstein directs the Friedman Diabetes Program at Lenox Hill Hospital in New York City. He wasn't involved in the new study, but is familiar with "AGE" chemicals as natural indicators of health.

"What's a good example of an AGE that everyone can recognise? On Thanksgiving we put a turkey in the oven with the goal of having a beautiful bird with beautiful browned skin. That browning occurs because of the AGEs in the turkey skin," Dr Bernstein noted.

Not to be used in nonclinical settings

He explained that in live humans, these proteins "stick to each other and form a web, and this web is an AGE. The formation of AGEs contribute to the complications of diabetes."

Because AGEs can gradually increase over time, doctors might someday "easily screen whole populations by the fluorescent technique to identify who has AGEs and is therefore at risk", Dr Bernstein said.

A heart specialist agreed. Dr Guy Mintz called the study "impressive", and said devices like the AGE Reader "could be a game-changer in cardiovascular and diabetic risk assessment". He directs cardiovascular health at North Shore University Hospital in Manhasset, New York.

Dr Mintz said studies where the AGE Reader was used on a patient's skin before and after medical treatments would be interesting "to see if the pattern of skin autofluorescence changes with medical and lifestyle interventions".

However, Dr Mintz did have one reservation: "I do not agree with the author's [notion] that this technology can be used in nonclinical settings, such as pharmacies, to assess patients' risk." He said non-physicians could easily misinterpret test results and that might harm, not help, patients.

Image credit: iStock

 

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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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