Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May 14:5:10198.
doi: 10.1038/srep10198.

A new gender-specific model for skin autofluorescence risk stratification

Muhammad S Ahmad  1 , Zoheir A Damanhouri  2 , Torben Kimhofer  3 , Hala H Mosli  4 , Elaine Holmes  5
Affiliations

A new gender-specific model for skin autofluorescence risk stratification

Muhammad S Ahmad et al. Sci Rep. .

Erratum in

Abstract

Advanced glycation endproducts (AGEs) are believed to play a significant role in the pathophysiology of a variety of diseases including diabetes and cardiovascular diseases. Non-invasive skin autofluorescence (SAF) measurement serves as a proxy for tissue accumulation of AGEs. We assessed reference SAF and skin reflectance (SR) values in a Saudi population (n = 1,999) and evaluated the existing risk stratification scale. The mean SAF of the study cohort was 2.06 (SD = 0.57) arbitrary units (AU), which is considerably higher than the values reported for other populations. We show a previously unreported and significant difference in SAF values between men and women, with median (range) values of 1.77 AU (0.79-4.84 AU) and 2.20 AU (0.75-4.59 AU) respectively (p-value « 0.01). Age, presence of diabetes and BMI were the most influential variables in determining SAF values in men, whilst in female participants, SR was also highly correlated with SAF. Diabetes, hypertension and obesity all showed strong association with SAF, particularly when gender differences were taken into account. We propose an adjusted, gender-specific disease risk stratification scheme for Middle Eastern populations. SAF is a potentially valuable clinical screening tool for cardiovascular risk assessment but risk scores should take gender and ethnicity into consideration for accurate diagnosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Comparison of SAF values between different cohorts. Saudi men (black) had similar SAF values to the Dutch’s (cyan) and Slovak’s (green). Increased SAF values have been observed for the Saudi women (grey). This relation was also true if the full cohort was reduced to a subset of healthy individuals, defined by the absence of diseases (dashed lines).
Figure 2
Figure 2
Correlation heatmaps stratified for gender and diabetes. (A) The upper triangular matrix shows correlations among variables for women, the lower triangular matrix for men. (B) The upper triangular matrix shows correlations among variables for diabetic subjects, the lower triangular matrix for non-diabetic subjects.
Figure 3
Figure 3
Orthogonal partial least squares regression (OPLSR) model for women. (A) Scores plot (B) Loading plot. Variables with high influence include age, diabetes, hypertension and SR. Hypertension and SR seems to be less influential for men (Fig. 4).
Figure 4
Figure 4
Orthogonal partial least squares regression (OPLSR) model for men. (A) Scores plot (B) Loading plot. Variables with high influence include age and diabetes. Hypertension and SR seems to be less important in men than in women (Fig. 3).
Figure 5
Figure 5
SAF stratified for diabetes and gender. In Saudi men (blue) and women (red), diabetic subjects (solid lines) had increased SAF values when compared to non-diabetic subjects (dashed lines). In later age stages, this difference seems to be more pronounces in women than in men.
Figure 6
Figure 6
Proposed CVD risk stratification for Saudi cohort. (A) Men (B) Women with low SR values and (C) Women with high SR values. The background colour indicates the predicted risk group. The boundaries for the original risk stratification groups by Koetsier et al. are indicated by the dashed lines where the red dashed line represents the cut off for the highest risk group for CVD. Based on the original boundaries, it can be seen that the majority of women participants with high SR values (C) sub-cohort are allocated to the risk groups II and III.
Figure 7
Figure 7
Comparison of risk score distributions for Saudi cohort. The original model developed by Koetsier et al. and the new proposed model are compared for (A) Men, (B) Women with low SR values and (C) Women with high SR values.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ahmed N. Advanced glycation endproducts--role in pathology of diabetic complications. Diabetes research and clinical practice 67, 3–21, 10.1016/j.diabres.2004.09.004 (2005). - DOI - PubMed
    1. van Heijst J. W., Niessen H. W., Hoekman K. & Schalkwijk C. G. Advanced glycation end products in human cancer tissues: detection of Nepsilon-(carboxymethyl)lysine and argpyrimidine. Annals of the New York Academy of Sciences 1043, 725–733, 10.1196/annals.1333.084 (2005). - DOI - PubMed
    1. Hegab Z., Gibbons S., Neyses L. & Mamas M. A. Role of advanced glycation end products in cardiovascular disease. World journal of cardiology 4, 90–102, 10.4330/wjc.v4.i4.90 (2012). - DOI - PMC - PubMed
    1. Schmidt A. M., Yan S. D., Wautier J. L. & Stern D. Activation of receptor for advanced glycation end products: a mechanism for chronic vascular dysfunction in diabetic vasculopathy and atherosclerosis. Circulation research 84, 489–497 (1999). - PubMed
    1. Sasaki N. et al. Advanced glycation end products in Alzheimer’s disease and other neurodegenerative diseases. Am. J. Pathol. 153, 1149–1155, 10.1016/S0002-9440(10)65659-3 (1998). - DOI - PMC - PubMed

MeSH terms

Substances