Skin autofluorescence, a measure of tissue accumulation of advanced glycation end products, is associated with subclinical atherosclerosis in coronary and carotid arteries

Background and aims: Skin autofluorescence (AF), a measure of tissue accumulation of advanced glycation end products (AGEs), has been associated with diabetes and cardiovascular disease. However, the association of skin AF with subclinical coronary atherosclerosis in the general population is largely unknown. Our study aimed to examine the associations between skin AF and subclinical atherosclerosis in coronary and carotid arteries in a middle-aged population. Methods: Skin AF and subclinical atherosclerosis were measured in 4416 subjects (aged 50-64 years) from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Skin AF was measured non-invasively using an auto-fluorescence reader. Subclinical atherosclerosis was assessed by ultrasonography of carotid arteries for evalua-tion of carotid plaques and computed tomography for the evaluation of the coronary artery calcium score (CACS). Results: A total of 615 (13.9%) individuals had CACS > 100 and 1340 (30.3%) subjects had bilateral carotid plaques (median total plaque area: 8 mm(2)). After controlling for confounding factors, there were significant associations between skin AF (per 1 standard deviation (SD) increase) and CACS > 100: odds ratio (OR) = 1.17, 95% confidence interval (CI): 1.06-1.29, p = 0.001. Total carotid plaque area and occurrence of bilateral carotid plaques (OR per 1 SD increase: 1.10, 95%CI: 1.01-1.19, p = 0.02) were similarly associated with skin AF after multivariable adjustments. Conclusions: Elevated skin AF was significantly associated with subclinical atherosclerosis in coronary and carotid arteries independently of conventional risk factors. Skin AF, a measure of accumulation of AGEs, could be a marker for the identification of middle-aged subjects with elevated atherosclerotic risk.