Skin Autofluorescence as a Measure of Advanced Glycation End Products Deposition Predicts 5-Year Amputation in @entity1 With XXXX .

@entity1 @entity6 @entity3657 @entity63 @entity272
OBJECTIVE: @entity1 with @entity3657 are at risk for @entity63 and amputation. Accumulation of advanced glycation end products is increased and predictive for coronary and cerebrovascular events in several high cardiovascular risk groups. We hypothesized that accumulation of tissue advanced glycation end products, measured by @entity272 ( @entity272 ), predicts amputation in @entity1 with @entity3657 . APPROACH AND RESULTS: Between October 2007 and June 2008, 252 @entity1 with @entity3657 were included at the outpatient clinic. During a 5-year follow-up, 22 (9%) had an amputation because of @entity63 . Competing risk analysis showed a subproportional hazard ratio of 3.05 (95% confidence interval [CI], 1.87-4.96); P<0.0001 for amputation per unit of @entity272 . After correction for @entity6 and Fontaine stage, subproportional hazard ratio was 2.72 (95% CI, 1.38-5.39); P=0.004. In @entity1 with Fontaine stage I and II only (n=215), @entity272 was the only predictor for amputation, subproportional hazard ratio, 4.05 (95% CI, 2.09-7.83); P<0.0001. Fontaine stage multiplied by @entity272 resulted in a significant increase of the area under the curve for prediction of amputation when compared with Fontaine stage only: area under the curve increased from 0.74 (95% CI, 0.63-0.86) to 0.83 (95% CI, 0.74-0.92); P=0.003. CONCLUSIONS: Skin autofluorescence, as a measure of tissue advanced glycation end products deposition, predicts amputation in @entity1 with @entity3657 during a 5-year follow-up, independent from the presence of @entity6 and Fontaine stage. Even at lower Fontaine stage (I or II), @entity272 is a strong predictor of amputation. The multiplication of Fontaine stage by @entity272 results in a good prediction model of amputation.
