Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Original Article

Volume 9, Number 2, April 2018, pages 83-89


Clinical Significance of Skin Autofluorescence in Patients With Type 2 Diabetes Mellitus With Chronic Heart Failure

Figures

Figure 1.
Figure 1. Comparisons of skin AF values between patients with and without history of heart failure admission. The skin AF levels in patients with a history of hospitalization due to HF were significantly higher than those without a history of hospitalization due to HF (3.0 ± 0.5 AU vs. 2.7 ± 0.5 AU, respectively, P < 0.001) even though mean age was similar between the two groups (80 ± 7 years vs. 79 ± 7 years, respectively). *P < 0.001 vs. non-history of HF hospitalization. AF: autofluorescence; HF: heart failure; AU: arbitrary units.
Figure 2.
Figure 2. Results of multiple logistic regression analysis of heart failure hospitalization or high hs-cTnT levels. (a) Subordinate factor is heart failure hospitalization. Adjustment factors are hs-cTnT, E/e′, CAVI, d-ROMs test, and age. (b) Subordinate factor is high hs-cTnT levels. High hs-cTnT was defined as hs-cTnT ≥ 0.018 ng/mL. Adjustment factors are E/e′, history of heart failure hospitalization, CAVI, d-ROMs test, and age. *P < 0.05 vs. skin AF ≤ 2.5 AU; **P < 0.01 vs. skin AF ≤ 2.5 AU, ***P < 0.001 vs. skin AF ≤ 2.5 AU. hs-cTnT: high-sensitivity cardiac troponin T; CAVI: cardio-ankle vascular index; d-ROMs: derivatives of reactive oxygen metabolites; AU: arbitrary units.

Tables

Table 1. Patient Characteristics
 
Continuous values are mean ± SD. HF: heart failure; HOMA-IR: homeostasis assessment insulin resistance; IVSTd: interventricular septal thickness at end-diastole; LVDd: left ventricular end-diastolic diameter; LVEF: left ventricular ejection fraction; LAD: left atrial dimension; eGFR: estimated glomerular filtration rate; BNP: brain natriuretic peptide; hs-cTnT: high-sensitivity cardiac troponin T; d-ROMs: derivatives of reactive oxygen metabolites; CAVI: cardio-ankle vascular index; DPP: dipeptidyl peptidase; RAS: renin-angiotensin system.
n (male/female)257 (96/161)
Age (years)79 ± 7
Skin autofluorescence (AU)2.8 ± 0.5
Body mass index22.8 ± 0.6
Current smoker, n (%)30 (12)
Ischemic heart disease, n (%)39 (15)
HF hospitalization, n (%)60 (23)
Hypertension, n (%)202 (79)
Systolic blood pressure (mm Hg)139 ± 17
Diastolic blood pressure (mm Hg)81 ± 10
Dyslipidemia, n (%)172 (67)
Fasting blood glucose (mg/dL)143 ± 26
HOMA-IR2.8 ± 1.8
Hemoglobin A1c (%)7.3 ± 1.0
Heart valvular disease, n (%)189 (74)
IVSTd (mm)9.8 ± 1.8
LVDd (mm)50.0 ± 3.6
LVEF (%)68.8 ± 12.8
LAD (mm)42.5 ± 5.6
E/e′9.6 ± 3.7
eGFR (mL/min/1.73 m2)48.4 ± 17.6
Log-BNP (pg/mL)2.0 ± 0.3
Log-hs-cTnT (ng/mL)-2.0 ± 0.3
d-ROMs test (U. CARR)336 ± 108
CAVI9.7 ± 1.4
Medication
  Sulfonylurea, n (%)186 (72)
  Biguanide, n (%)41 (16)
  DPP-4 inhibitor, n (%)155 (60)
  Insulin, n (%)26 (10)
  RAS inhibitor, n (%)169 (66)
  β-blocker, n (%)56 (22)
  Diuretics, n (%)40 (16)
  Statin, n (%)159 (62)

 

Table 2. Relationship Between Skin AF and Various Clinical Parameters
 
rP value
r expressed correlation coefficient. HOMA-IR: homeostasis assessment insulin resistance; IVSTd: interventricular septal thickness at end-diastole; LVDd: left ventricular end-diastolic diameter; LVEF: left ventricular ejection fraction; LAD: left atrial dimension; eGFR: estimated glomerular filtration rate; BNP: brain natriuretic peptide; hs-cTnT: high-sensitivity cardiac troponin T; d-ROMs: derivatives of reactive oxygen metabolites; CAVI: cardio-ankle vascular index; DPP: dipeptidyl peptidase; RAS: renin-angiotensin system.
Sex (female = 0, male = 1)-0.010.065
Age0.12< 0.05
Body mass index0.060.363
Current smoker (no = 0, yes = 1)0.12< 0.05
Ischemic heart disease (no = 0, yes = 1)0.13< 0.05
Hypertension (no = 0, yes = 1)0.030.631
Systolic blood pressure0.090.158
Diastolic blood pressure0.020.700
Dyslipidemia (no = 0, yes = 1)0.040.527
Fasting blood glucose0.050.448
HOMA-IR0.060.372
Hemoglobin A1c0.16< 0.01
Heart valvular disease (no = 0, yes = 1)0.050.433
IVSTd0.040.523
LVDd0.030.563
LVEF0.040.514
LAD0.12< 0.05
E/e′0.30< 0.001
eGFR-0.16< 0.01
Log-BNP0.29< 0.001
Log-hs-cTnT0.45< 0.001
d-ROMs test0.31< 0.001
CAVI0.38< 0.001
Sulfonylurea (no = 0, yes = 1)0.030.684
Biguanide (no = 0, yes = 1)0.040.507
DPP-4 inhibitor (no = 0, yes = 1)-0.070.242
Insulin (no = 0, yes = 1)0.020.811
RAS inhibitor (no = 0, yes = 1)-0.090.158
β-blocker (no = 0, yes = 1)0.050.429
Diuretics (no = 0, yes = 1)0.030.679
Statin (no = 0, yes = 1)-0.020.701

 

Table 3. Multiple Regression Analysis for Skin AF
 
Explanatory factorβP value
R2 = 0.31. AF: autofluorescence; hs-cTnT: high-sensitivity cardiac troponin T; CAVI: cardio-ankle vascular index; HF: heart failure; d-ROMs: derivatives of reactive oxygen metabolites; eGFR: estimated glomerular filtration rate; β: standardized regression coefficient; R2: coefficient of determination.
Log-hs-cTnT0.30< 0.001
E/e′0.25< 0.001
HF hospitalization0.23< 0.001
CAVI0.21< 0.001
d-ROMs test0.15< 0.01
Age0.13< 0.05
eGFR-0.080.144