Introduction and Objective: Diabetic retinopathy (DR) is one of the most frequent microvascular complications of type 1 diabetes (T1D) and advanced glycation end products (AGEs) play a major pathogenic role. The relationship between AGEs and the presence and the degree of DR in individuals with T1D has not been fully established. Objectives: To evaluate the association between cutaneous AGEs and both the presence and severity of DR. Methods: This cross-sectional study included adults with T1D using continuous glucose monitoring systems (GCM). Cutaneous AGEs were assessed by skin autofluorescence. Clinical variables including the presence and severity of DR and standard GCM-derived metrics were recorded. Descriptive analyses, non-parametric tests, multivariable logistic and ordinal logistic regression models were performed. Results: A total of 98 individuals with T1D were included (mean age 42.1 ± 13.5 years; mean diabetes duration 21.5 ± 11.6 years); 31 (31.6%) had DR: 11 (35.5%) mild DR, 13 (41.9%) moderate DR and 7 (22.6%) severe DR. AGEs were significantly higher in individuals with DR compared with those without (2.67 ± 0.53 vs 2.27 ± 0.57; p0.001). In multivariable logistic regression analyses, AGEs were independently associated with the presence of DR (OR 3,88; CI95% 1,25-13,0; p = 0,022). In the adjusted ordinal logistic regression model, AGEs were independently associated with greater DR severity (OR 3.98; CI95% 1.37-12.15). Diabetes duration was also an independent predictor of severe DR (OR 1.08 per year; CI95% 1.03-1.13). We did not observe any independent relationship between HbA1c and CGM-derived metrics and the presence and degree of DR. Finally, a positive correlation was observed between AGEs and DR severity (p 0.001). Conclusion: In individuals with T1D, cutaneous AGEs were independently associated with both the presence and severity of DR. Longitudinal studies are needed to determine the prognostic value of AGEs in DR progression. Disclosure A. Rojano-Toimil: Other - travel and congress support; Ended; Novo Nordisk, Lilly. P. Gil-Millán: None. Á. Ortiz Zúñiga: None. A. Lecube: None. O. Simó-Servat: Advisory Panel; Current; Abbott Diabetes. Other - Speaker on a meeting; Ended; Tandem Diabetes Care, Inc. C. Hernández: None. R. Simo: Research Support; Current; Abbott, Dexcom, Inc., Novo Nordisk. Board Member; Current; D-Sight.
Rojano‐Toimil et al. (Fri,) studied this question.