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Background  Skin collagen Long Wavelength Fluorescence (LWF) is widely used as a surrogate marker for accumulation of advanced glycation end-products. Here we determined the relationship of LWF with glycemia, skin fluorescence, and the progression of complications during EDIC in 216 participants from the DCCT.    Methods  LW-1 and collagen-linked fluorescence (CLF) were measured by either High Performance Liquid Chromatography (HPLC) with fluorescence detection (LW-1) or total fluorescence of collagenase digests (CLF) in insoluble skin collagen extracted from skin biopsies obtained at the end of the DCCT (1993). Skin intrinsic fluorescence (SIF) was noninvasively measured on volar forearm skin at EDIC year 16 by the SCOUT DS instrument.    Results  LW-1 levels significantly increased with age and diabetes duration (P < 0.0001) and significantly decreased by intensive  vs.  conventional glycemic therapy in both the primary (P < 0.0001) and secondary (P < 0.037) DCCT cohorts. Levels were associated with 13–16 year progression risk of retinopathy (>3 sustained microaneurysms, P = 0.0004) and albumin excretion rate (P = 0.0038), the latter despite adjustment for HbA 1c . Comparative analysis for all three fluorescent measures for future risk of subclinical  macrovascular disease  revealed the following significant (P < 0.05) associations after adjusting for age, diabetes duration and HbA 1c : coronary artery calcium with SIF and CLF; intima-media thickness with SIF and LW-1; and left ventricular mass with LW-1 and CLF.    Conclusions  LW-1 is a novel risk marker that is robustly and independently associated with the future progression of microvascular disease, intima-media thickness and left ventricular mass in type 1 diabetes.   Trial registration  NCT00360815 and NCT00360893 at clinicaltrials.gov    Electronic supplementary material  The online version of this article (doi:10.1186/s12933-016-0343-3) contains supplementary material, which is available to authorized users.

cardiovascular diabetology

Skin collagen fluorophore LW-1 versus skin fluorescence as markers for the long-term progression of subclinical macrovascular disease in type 1 diabetes