Objective: The aim of this study was to investigate the relationship between SAF and CHD in the general population of China and to assess the feasibility of SAF used as a predictor of CHD.
Methods: This study was nested within the prospective study REACTION (Cancer Risk Assessment in Chinese Diabetic Population) which included a total of 5806 eligible participants from two communities located in urban Beijing in 2018. SAF were measured using a fluorescence detector (DM Scan). CHD was the study endpoint and was determined by a face-to-face clinical survey. Pearson's correlation analysis, linear regression analysis, and binary logistic regression analysis were used to examine the association between SAF and CHD.
Results: The overall prevalence of CHD in the general population was 12.1%. Logistic analysis showed that after full adjustment for confounding factors, the risk of CHD increased significantly with increasing lnSAF quartiles (p-trend < 0.05). Compared to Q1 group, the multivariate adjusted ORs of Q2 and Q3 groups were 1.071 (0.817, 1.404), 1.025 (0.781, 1.344), respectively, and the OR was markedly increased at Q4 (OR = 1.377 [1.043, 1.817]). When lnSAF was a continuous variable, the risk of CHD increased with the elevation of lnSAF level. Stratified analysis showed that in subgroups with overweight (24-28 kg/m2), eGFR < 60 mL/min/1.73 m2, and diabetes mellitus (DM), lnSAF was still significantly correlated with CHD.
Conclusions: In Chinese general population, higher lnSAF is independently associated with increased risk of CHD, and noninvasive SAF holds the potential to be a biomarker for CHD risk evaluation and stratification.
Keywords: REACTION study; advanced glycation end products; coronary heart disease; skin autofluorescence.
© 2025 The Author(s). Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.