Skin autofluorescence for non-enzymatic glycation end products in Diabetic Foot Ulcers (DFUs)- A meta analysis

Continued efforts to create companion diagnostics and theragnostics to help us measure what we manage and predict DFU risk. Imagine diagnosing “friable” tissue and then doing something about it?!

Objective: Skin autofluorescence (SAF) has been suggested as a novel and noninvasive technique for assessing tissue accumulation of advanced glycation end products in diabetes and related complications. The aim of this systematic review and meta-analysis was to evaluate the use of SAF in diabetic foot ulcers (DFUs).

Data sources: PubMed/MEDLINE and other digital databases.

Study selection: The authors included studies comparing the SAF levels in patients with DFU with a non-DFU group to determine its association with DFU risk.

Data extraction: Collected data included the SAF method and its values in DFU and non-DFU groups, covariates used in adjustment along with the unadjusted and/or multivariate adjusted odds ratios (ORs) for the association of SAF with DFU risk, and other study characteristics.

Data synthesis: A total of six studies were included in this meta-analysis. Five studies that involved 611 participants were included to compare SAF methods. Compared with the non-DFU group, the DFU group showed a significantly increased level of SAF (standardized mean difference, 0.67; 95% confidence interval [CI], 0.32-1.01; P < .001). The results of meta-analysis of ORs revealed that the increased SAF level was independently associated with increased DFU risk in both unadjusted (OR, 3.16; 95% CI, 2.18-4.57; P < .001) and adjusted models (OR, 3.07; 95% CI, 1.95-4.81; P < .001).

Conclusions: These findings suggest that SAF could be useful as a novel and noninvasive technology to help determine DFU risk. However, further studies establishing its diagnostic and prognostic utilities are needed.

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