Malindu E Fernando1,2, Robert G Crowther3, Peter A Lazzarini2,4, Kunwarjit S Sangla5, Scott Wearing2,6, Petra Buttner7, Jonathan Golledge1,8. 1. 1 Ulcer and Wound Healing Consortium (UHEAL), Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia. 2. 2 School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia. 3. 3 School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. 4. 4 Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Australia. 5. 5 Department of Diabetes and Endocrinology, Townsville Hospital, Queensland, Australia. 6. 6 Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. 7. 7 Centre for Chronic Disease Prevention, James Cook University, Cairns, Australia. 8. 8 Department of Vascular and Endovascular Surgery, Townsville Hospital, Queensland, Australia.
Abstract
BACKGROUND: Skin autofluorescence has been used to assess longer term glycemic control and risk of complications. There is however no agreed site at which autofluorescence should be measured. This study evaluated the within- and between-site agreement in measurement of skin autofluorescence using a noninvasive advanced glycation end product (AGE) reader. METHODS: Overall, 132 participants were included: 16 with diabetes-related foot ulcers (DFU), 63 with diabetes but without foot ulcers (DMC), 53 without diabetes or foot ulcers (HC). Skin autofluorescence was measured using the AGE Reader (DiagnOptics technologies BV, the Netherlands). Three consecutive skin autofluorescence measurements were each performed at six different body sites: the volar surfaces of both forearms (arms), dorsal surfaces of both calves (legs), and plantar surfaces of both feet (feet). Within- and between-site agreements were analyzed with concordance correlation coefficients (CCC) and 95% confidence intervals (95% CI), absolute mean differences (±standard deviation), and Bland-Altman limits of agreement. RESULTS: The agreement between repeat assessments at the same site was almost perfect (CCC [95% CI] ranging from 0.94 [0.91-0.96] for assessments in the right foot to 0.99 [0.99-0.99] for assessments in the left arm). The limits of agreement were narrow within ±0.5 arbitrary units for all sites. The between-site agreement in measurements was poor (CCC < 0.65) with large maximum absolute mean differences (±SD) in arbitrary units (DFU = 3.40 [±2.04]; DMC = 3.15 [±2.45]; HC = 2.72 [±1.83]) and wide limits of agreement. CONCLUSIONS: Skin autofluorescence measurements can be repeated at the same site with adequate repeatability but measurements at different sites in the same patient have marked differences. The reason for this variation across sites and whether this has any role in diabetes-related complications needs further investigation.
BACKGROUND: Skin autofluorescence has been used to assess longer term glycemic control and risk of complications. There is however no agreed site at which autofluorescence should be measured. This study evaluated the within- and between-site agreement in measurement of skin autofluorescence using a noninvasive advanced glycation end product (AGE) reader. METHODS: Overall, 132 participants were included: 16 with diabetes-related foot ulcers (DFU), 63 with diabetes but without foot ulcers (DMC), 53 without diabetes or foot ulcers (HC). Skin autofluorescence was measured using the AGE Reader (DiagnOptics technologies BV, the Netherlands). Three consecutive skin autofluorescence measurements were each performed at six different body sites: the volar surfaces of both forearms (arms), dorsal surfaces of both calves (legs), and plantar surfaces of both feet (feet). Within- and between-site agreements were analyzed with concordance correlation coefficients (CCC) and 95% confidence intervals (95% CI), absolute mean differences (±standard deviation), and Bland-Altman limits of agreement. RESULTS: The agreement between repeat assessments at the same site was almost perfect (CCC [95% CI] ranging from 0.94 [0.91-0.96] for assessments in the right foot to 0.99 [0.99-0.99] for assessments in the left arm). The limits of agreement were narrow within ±0.5 arbitrary units for all sites. The between-site agreement in measurements was poor (CCC < 0.65) with large maximum absolute mean differences (±SD) in arbitrary units (DFU = 3.40 [±2.04]; DMC = 3.15 [±2.45]; HC = 2.72 [±1.83]) and wide limits of agreement. CONCLUSIONS: Skin autofluorescence measurements can be repeated at the same site with adequate repeatability but measurements at different sites in the same patient have marked differences. The reason for this variation across sites and whether this has any role in diabetes-related complications needs further investigation.
Authors: Robbert Meerwaldt; Jasper W L Hartog; Reindert Graaff; Roel J Huisman; Thera P Links; Nynke C den Hollander; Susan R Thorpe; John W Baynes; Gerjan Navis; Rijk O B Gans; Andries J Smit Journal: J Am Soc Nephrol Date: 2005-11-09 Impact factor: 10.121
Authors: R Meerwaldt; T P Links; R Graaff; K Hoogenberg; J D Lefrandt; J W Baynes; R O B Gans; A J Smit Journal: Diabetologia Date: 2005-07-14 Impact factor: 10.122
Authors: H L Lutgers; E G Gerrits; R Graaff; T P Links; W J Sluiter; R O Gans; H J Bilo; A J Smit Journal: Diabetologia Date: 2009-03-10 Impact factor: 10.122
Authors: Malindu Fernando; Robert G Crowther; Margaret Cunningham; Peter A Lazzarini; Kunwarjit S Sangla; Petra Buttner; Jonathan Golledge Journal: J Foot Ankle Res Date: 2016-01-29 Impact factor: 2.303
Authors: Johann M E Jende; Christoph Mooshage; Zoltan Kender; Stefan Kopf; Jan B Groener; Sabine Heiland; Alexander Juerchott; Peter Nawroth; Martin Bendszus; Felix T Kurz Journal: Front Neurosci Date: 2022-02-15 Impact factor: 4.677
Authors: Dominik Adl Amini; Manuel Moser; Erika Chiapparelli; Lisa Oezel; Jiaqi Zhu; Ichiro Okano; Jennifer Shue; Andrew A Sama; Frank P Cammisa; Federico P Girardi; Alexander P Hughes Journal: J Clin Med Date: 2022-08-12 Impact factor: 4.964