皮肤糖基化终产物无创检测筛查2型糖尿病的临床应用

Clinical application of non-invasive detection of skin advanced glycation end products in type 2 diabetes

目的评估皮肤AGE无创检测技术在糖尿病筛查中的应用价值。方法选取208例T2DM患者和119名健康体检者行体征检查、生化检测,采用基于AGE光学检测技术的糖尿病无创检测仪(DM Scan)对受试者上臂皮肤组织中的AGE进行无创检测,采用受试者工作特征(ROC)曲线评价其敏感性和特异性。结果≤30岁、30~50岁和≥50岁糖尿病患者AGE均高于健康受试者[(56.2±4.1)vs(71.3±8.4)AU、(62.0±5.9)vs(70.6±6.2)AU、(62.5±6.9)vs(75.8±8.4)AU](P<0.01)。Pearson相关分析显示,AGE与FPG(r=0.417,P<0.01)和HbA_1c(r=0.500,P<0.01)相关。多元回归分析显示,AGE值与糖尿病发病风险密切相关[OR1.322,95%CI(1.228,1.424),P<0.01]。DM Scan检测皮肤AGE的ROC为0.941[95%CI(0.917,0.965)],AGE切点65.00AU时对应的敏感性为88.5%,特异性为89.9%。结论 DM Scan检测皮肤AGE筛查T2DM有较高的敏感性和特异性,有望成为一种新的无创糖尿病筛查工具。

Objective To evaluate the application of non-invasive detection of skin advanced glycation end products （AGE） in the screening for diabetes. Methods DM Scan is a skin fluorescence spectrometer that reports a risk score of AGE following a 2 - 3 min noninvasive measurement on left forearm. Skin AGE was detected by DM Scan in 327 subjects （208 with T2DM, 119 as controls）. Sensitivity,specificity and area under the receiver operating characteristic curve for DM detection were calculated. Results The levels of AGE in diabetes group were higher than control group [Low age group： （56.2±4. 1） vs （71.3±8.4）AU;Medium age group： （62.0±5.9） vs （70. 6±6.2）AU; High age group： （62. 5±6.9） vs （75.8±8.4）AU,P〈0. 01]. Logistic regression analysis showed that the level of skin AGE was associated with diabetes. Pearson correlation analysis showed that AGE was positively correlated with FPG （r= 0. 417, P±0.01） and HbA1c （r： 0. 500, P〈0.01）. The optimal cut point of skin AGE took 65.00 AU, with area under curve for diabetes detection 0. 941[95% CI（0. 917,0. 965）], the sensitivity 88. 5%and the specificity 85.6%. Conclusion DM Scan maybecome a new approach for rapid screening diabetes with reasonable sensitivity and specificity.