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Purpose
The accumulation of advanced glycation end products (AGEs) in local tissue is an important cause of low-grade inflammation and oxidative stress and is linked to late diabetic complications. Physical activity has various beneficial cardiometabolic effects in type 1 diabetes (T1D) and is associated with lower frequency of chronic complications of diabetes, although the specific mechanisms still remain unclear. The present study determines the association between self-reported physical activity and skin autofluorescence (AF), a marker of tissue accumulation of AGEs in adults with T1D.Methods
We enrolled 119 patients (63 women), aged 34 years (interquartile range [IQR], 26–41 years), with T1D duration of 17 years (IQR, 12–25 years), glycosylated hemoglobin (HbA1c) of 7.9% (IQR, 7.1%–8.9%) referred to an outpatient diabetes clinic. Patients with diabetes duration of <5 years, age >65 years, concomitant diabetic ketoacidosis, and severe complications that restrict physical activity (eg, diabetic foot, diabetic proliferative retinopathy, blindness) were excluded. Physical activity was measured with the short version of the International Physical Activity Questionnaire (IPAQ-SF), and raw scores were then log-transformed because of non-normality. The accumulation of AGEs in the skin was assessed on the basis of skin AF. Correlations between AF and various laboratory and clinical findings were assessed, and multivariate linear regression analysis was used to examine factors that influenced AGEs.Findings
Skin AF correlated positively with age (Spearman’s coefficient [Rs] = 0.47; P < 0.0001), HbA1c (Rs = 0.30; P = 0.001), waist-to-hip ratio (WHR; Rs = 0.23; P = 0.02), and negatively with logIPAQ-SF (Rs = –0.28; P = 0.002). A stepwise multivariable linear regression analysis indicated age (β = 0.46; P < 0.0001), HbA1c (β = 0.21; P = 0.01), and logIPAQ-SF score (β = –0.17; P = 0.04) as predictors of the skin AF after adjustment for sex and WHR (R2 = 0.36; P < 0.0001).Implications
Higher physical activity is related to lower accumulation of AGEs in patients with T1D. Our study provides new insight into the beneficial effects of physical activity in T1D according to tissue accumulation of AGEs. 相似文献The aim of the study was to assess the effectiveness of Superb Micro-vascular Imaging (SMI) as an alternative to Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography Angiography (CTA) for endoleak detection and classification in patients followed up after endovascular abdominal aortic aneurysm repair (EVAR).
Materials and methodsFrom May 2015 to January 2017, 30 patients underwent post-EVAR follow-up with Color Doppler Ultrasound (CDUS), CEUS, SMI, and CTA examinations. Aneurysmal sac diameter and graft patency were evaluated; endoleaks were identified and classified. Sensitivity, specificity, and accuracy values were calculated for each of the four diagnostic methods of endoleak detection. A percentage of agreement and Cohen’s Kappa coefficient were calculated for comparison of methods in terms of endoleak identification.
ResultsCTA revealed fifteen endoleaks (50%): three type Ia, nine type II, and three type III. The sensitivity of CDUS, CEUS, and SMI relative to CTA was 27%, 100%, and 100%, respectively. Specificity was 93%, 93%, and 93%, respectively. Accuracy was 60%, 97%, and 97%, respectively. There were no differences between SMI and CEUS in terms of sensitivity, specificity, or accuracy (100%, 93%, and 97%). We do not observe statistically significant differences between CTA, CEUS, and SMI concerning endoleak identification ability. The weakest method in endoleak identification was CDUS.
ConclusionsThe analysis showed that SMI is effective, repeatable, and comparable with the CEUS modality in identification endoleaks after EVAR; it may be considered as a potential tool to monitor patients after EVAR implantation, especially those with renal insufficiency or with an allergy to any contrast media.
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