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Lens autofluorescence ratio as a noninvasive marker of peripheral diabetic neuropathy.

INTRODUCTION Diabetes and its complications are a significant cause of morbidity and mortality. Advanced glycation endproducts (AGEs) play a major role in the pathogenesis of  diabetes complications. OBJECTIVES To investigate the possible uses of a biomicroscope (ClearPath DS-120) that shows age-adjusted lens fluorescence ratios (LFRs) for the diagnosis of diabetic peripheral neuropathy (DPN). PATIENTS AND METHODS One hundred and sixty type 2 diabetic patients who underwent LFR measurement were recruited to this study.  DPN was defined as the presence of neuropathic pain and/or foot sensory loss. Neurothesiometer, monofilament test, and DN4 results were used to diagnose DPN. RESULTS The LFRs of 43 (27%) diabetic patients were higher than the expected levels. According to the DN4 questionnaire, 35 of 160 (21 %) patients had a neuropathic pain problem. Thirty-seven patients (23%) had higher vibration perception thresholds (VPTs) than expected (>25V). As assessed by the monofilament test, 42 (26%) patients seemed to be affected by DPN. All of the tests, when considered individually, showed that there were significantly higher DPN problems in the group with higher LFRs (p< 0.05). High LFR had a 50% sensitivity and 81 % specificity in the diagnosis of DPN. Although there was no significant difference in fasting blood glucose levels, we observed that HbA1c and diabetes duration were significantly higher in patients with higher LFRs (p< 0.05) CONCLUSION The non-invasive measurement of LFR likely has clinical utility for the detection of DPN.

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