Accelerated formation and accumulation of
advanced glycation end-products occur under circumstances of increased supply of substrates such as hyperglycaemic or oxidative stress and in age-related and
chronic diseases like
diabetes mellitus,
chronic renal failure,
neurodegenerative diseases,
osteoarthritis and also non-diabetic
atherosclerosis and chronic
heart failure.
Advanced glycation end-products accumulation occurs especially on long-lived
proteins such as
collagen in the skin and in vascular basement membranes leading to vascular damage. Adequate renal clearance capacity is an important factor in the effective removal of
advanced glycation end-products. The Autofluorescence Reader was developed as a marker, representative for tissue
advanced glycation end-products accumulation, easily applicable in a clinical setting, initially for predicting
diabetes related complications. Studies have already shown a relationship between skin autofluorescence and
diabetes complications, as well as its predictive value for total and cardiovascular mortality in
type 2 diabetes. Moreover skin autofluorescence was demonstrated to be superior to Haemoglobin A1c and other conventional risk factors.
Advanced glycation end-products have been proposed as a novel factor involved in the development and progression of chronic
heart failure. Assessment of
advanced glycation end-products accumulation in
end-stage renal disease and undergoing
renal replacement therapies patients has become of great importance. Cardiovascular and connective tissue disorders are very common in patients with
end-stage renal disease, and the accumulation of
advanced glycation end-products is significantly increased in these patients. Mortality is markedly increased in patients with decreased kidney function, particularly in patients with
end-stage renal disease. Skin
advanced glycation end-products levels are strong predictors of survival in haemodialysis patients independent of other established risk factors. The Autofluorescence Reader may be useful as a clinical tool for rapid assessment of risk for
advanced glycation end-products related long-term complications, not only in diabetes, but in other conditions associated with
advanced glycation end-products accumulation as well.