Within- and between-body-site agreement of skin autofluorescence measurements in people with and without diabetes-related foot disease
Date
2019
Authors
Fernando, M.E.
Crowther, R.G.
Lazzarini, P.A.
Sangla, K.S.
Wearing, S.
Buttner, P.
Golledge, J.
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Journal article
Citation
Journal of diabetes science and technology, 2019; 13(5):836-846
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Abstract
Background: Skin autofluorescence has been used to assess longer term glycemic control and risk of complications. There is however no agreed site at which autofluorescence should be measured. This study evaluated the within- and between-site agreement in measurement of skin autofluorescence using a noninvasive advanced glycation end product (AGE) reader
Methods: Overall, 132 participants were included: 16 with diabetes-related foot ulcers (DFU), 63 with diabetes but without foot ulcers (DMC), 53 without diabetes or foot ulcers (HC). Skin autofluorescence was measured using the AGE Reader (DiagnOptics technologies BV, the Netherlands). Three consecutive skin autofluorescence measurements were each performed at six different body sites: the volar surfaces of both forearms (arms), dorsal surfaces of both calves (legs),and plantar surfaces of both feet (feet). Within- and between-site agreements were analyzed with concordance correlationcoefficients (CCC) and 95% confidence intervals (95% CI), absolute mean differences (±standard deviation), and BlandAltman limits of agreement.
Results: The agreement between repeat assessments at the same site was almost perfect (CCC [95% CI] ranging from 0.94[0.91-0.96] for assessments in the right foot to 0.99 [0.99-0.99] for assessments in the left arm). The limits of agreement were narrow within ±0.5 arbitrary units for all sites. The between-site agreement in measurements was poor (CCC < 0.65) withlarge maximum absolute mean differences (±SD) in arbitrary units (DFU = 3.40 [±2.04]; DMC = 3.15 [±2.45]; HC = 2.72[±1.83]) and wide limits of agreement.
Conclusions: Skin autofluorescence measurements can be repeated at the same site with adequate repeatability but measurements at different sites in the same patient have marked differences. The reason for this variation across sites and whether this has any role in diabetes-related complications needs further investigation.
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Data source: Supplementary material, https://doi.org/10.1177/1932296819853555
Link to a related website: http://europepmc.org/articles/pmc6955457?pdf=render, Open Access via Unpaywall
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Copyright 2019 Diabetes Technology Society