Search

Aim: The aim of the present study was to investigate whether skin autofluorescence would improve the Finnish Diabetes Risk Score (FINDRISC) in detecting undiagnosed diabetes in a large population-based cohort., Methods: Included were participants from the Dutch LifeLines Cohort Study. Skin autofluorescence was assessed in an unselected subset of participants using the AGE Reader. After the exclusion of participants with previously diagnosed diabetes (n=1635), pregnant women (n=58) and those using corticosteroids (n=345), 79,248 subjects were eligible for analysis. Diabetes was defined as fasting plasma glucose ≥7.0mmol/L, non-fasting plasma glucose ≥11.1mmol/L or HbA1c ≥6.5% (48mmol/mol)., Results: Diabetes was detected in 1042 participants (aged 55±12 years; 54% male). Skin autofluorescence improved the area under the receiver operating characteristic (AUROC) curve of the FINDRISC model from 0.802 to 0.811 (P<0.001). Furthermore, the addition of skin autofluorescence to FINDRISC reclassified 8-15% of all participants into more accurate risk categories (NRI: 0.080, 95% CI: 0.052-0.110). The proportion of reclassified participants was especially high (>30%) in the intermediate (1% to <5% and 5% to<10%) risk categories. When skin autofluorescence was added to a simplified model (age+body mass index), its discriminatory performance was similar to the full model+skin autofluorescence (AUROC: 0.806, P=0.062)., Conclusion: Skin autofluorescence is a non-invasive tool that can be used to further improve the FINDRISC for diabetes detection. The new resultant model is especially useful for reclassifying people in the intermediate-risk categories, where additional blood glucose testing is needed to confirm the presence of diabetes., (Copyright © 2017 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

We hypothesized that apolipoprotein-E (apo-E) genotypes would be associated with plasma lipid indices in newborns of South Asian (SA) ancestry but not in newborns of African (Afr) ancestry. Cord blood was obtained by consecutive sampling at maternity hospitals in the Caribbean Islands of Trinidad and Curaçao. Apolipoprotein-E genotypes, cholesterol, triglycerides, apo-A, apo-B and Lipoprotein (a) (Lp(a)) were measured in 294 newborns in Trinidad and 234 in Curaçao. The apo-B/apo-AI ratio and an adapted lipid tetrad index (i.e. cholesterol x triglycerides x Lp(a)/apo-AI) were calculated. In Trinidad, apo-E allele frequencies and genotype distributions of Afr and SA were significantly (p < 0.001) different (Afr: n = 71: apo-e2 : e3 : e4 = 10.4 : 66.4 : 23.2%; SA: n = 98; e2 : e3 : e4 = 3.5 : 83.1: 13.4%). The Mixed group (SA + Afr) had apo-E allele frequencies in between those of SA and Afr groups (n = 115; e2 : e3 : e4 = 7 : 76 : 17%). Lipid indices of appropriate for gestational age and term newborns were comparable, except for lower Lp(a) (SA = 29+/-4; Afr = 46+/-5; Mixed = 41+/-5 mg L(-1)) and lower adapted lipid tetrad index (29.4+/-4.8; 41.9+/-5.4; 41.4+/-7.0) in SA. Apo-E allele frequencies of Curaçao newborns were: apo-e2 : e3 : e4 = 10.5 : 72.6 : 16.9%. Their Lp(a) levels were significantly higher (68+/-3 mg L(-1)) than that of the Trinidadian sample (38+/-3; p < 0.0001). Apolipoprotein-E4 had an apo-B-increasing effect and apo-E2 an apo-B-decreasing effect in Afr (r = 0.192, p = 0.003). Among Africans from Trinidad and Curaçao variations in apo-E4 and apo-E2 are associated with an apo-B-increasing effect and an apo-B-decreasing effect, respectively. There was no relationship between apo-E polymorphism and lipids among South Asians.