ArticleEuropean journal of medical research2026
Differential impact of advanced glycation end-products on cardiovascular risk across patient populations measured by skin autofluorescence: a meta-analysis.
Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundElevated skin autofluorescence (SAF), a marker of advanced glycation end-products (AGEs), predicts cardiovascular outcomes. However, the predictive value of SAF across diabetes mellitus (DM), chronic kidney disease (CKD), and atherosclerotic cardiovascular disease (ASCVD) remains incompletely compared. This meta-analysis aimed to clarify SAF's prognostic strength across these populations, highlighting potential mechanisms and therapeutic implications.
methodsWe performed a systematic search of PubMed, Embase, and Cochrane databases through March 2025, identifying prospective observational studies evaluating associations between SAF and cardiovascular outcomes. Primary endpoints included all-cause mortality, cardiovascular death, cardiovascular disease (CVD), and stroke. Subgroup analyses compared SAF's predictive value in patients stratified by ESRD status (ESRD vs. non-ESRD), dialysis modality (hemodialysis [HD] vs. peritoneal dialysis [PD]), and diabetes type (type 1 vs. type 2 DM).
resultsTwenty-four studies involving 12,361 participants were included. Elevated SAF significantly predicted increased risks of all-cause mortality (hazard ratio [HR] 1.59; 95% confidence interval [CI] 1.37-1.85, I
conclusionsElevated SAF predicts increased cardiovascular risk, with notably stronger associations in chronic kidney disease and end-stage renal disease. These findings support the biological relevance of systemic AGE accumulation. However, further prospective validation and decision-analytic studies are required to assess SAF's incremental predictive value beyond established scores and determine its clinical utility for risk stratification.
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