Skin autofluorescence is associated with intima media thickness and complements commonly used cardiovascular risk scores

Background and Aims: Skin autofluorescence (AF) is a non-invasive marker for Advanced Glycation Endproducts which are protein bound compounds derived from glycaemic and oxidative stress. We aimed to assess whether skin AF is associated with carotid intima media thickness (IMT) and vascular risk factors (VRFs), and complements cardiovascular risk scores in identifying subjects with increased IMT. Methods: This was a cross-sectional local sub study to the “Carotid Intima Media Thickness and IMT-Progression as Predictors of Vascular Events in a High Risk European Population (IMPROVE)” study. 186 subjects with ≥3 VRFs without a history of cardiovascular disease (CVD) were included. Skin AF was measured on the lower arm, using a prototype of the current AGE-Reader. IMT was measured with a high-resolution ESAOTE ultrasound system. Results: Skin AF correlated with IMT (r=0.15; P=0.039), C-reactive protein (r=0.19; P=0.015), leukocyte count (r=0.27; P<0.001), waist circumference (r=0.24; P=0.002), BMI (r=0.25; P=0.001), and fasting glucose (r=0.21; P=0.007), and was higher in smokers (P=0.038), even after correction for age. Combining FRS or SCORE with skin AF improved the prediction of IMT (see figure). Conclusion: Skin AF is age independently associated with carotid IMT, inflammation, and VRFs, and may add incremental information to global risk assessment scores in identifying asymptomatic subjects at high risk for CVD.