Noninvasive Skin Autofluorescence of Advanced Glycation End Products in Patients with Degenerative Cervical Myelopathy

Objective: To clarify the association between skin autofluorescence of advanced glycation end products (AGEs) and clinical outcomes and pain in patients with degenerative cervical myelopathy (DCM).

Methods: Consecutive patients with DCM were prospectively enrolled. AGEs assessed by skin autofluorescence (the AGE score) were examined at the middle fingertip in eligible patients. Patients were divided into lower AGE score (AGE-L) and higher AGE score (AGE-H) groups based on a cutoff AGE score of 0.54. Demographic data, laboratory data, maximum spinal cord compression, clinical outcomes, such as European Quality of Life-5 Dimensions, Neck Disability Index, and Japanese Orthopaedic Association score, and Numerical Rating Scale (NRS) score for neck, arm, hand, leg, and foot pain were compared between the two groups. Multiple linear regression analysis was performed to assess the association between the AGE score and the NRS score for pain in the lower limbs.

Results: Of the 263 patients, 93 were included in this study (41 with the AGE-L group and 52 with the AGE-H group). Demographic data, laboratory data, maximum spinal cord compression, and clinical outcomes were comparable between the two groups. The AGE-H group had significantly higher NRS scores for leg and foot pain than the AGE-L group. Multiple linear regression analysis revealed that higher AGE scores were significantly associated with more severe pain in the lower limbs in patients with DCM.

Conclusions: Noninvasive skin autofluorescence of AGEs may be a useful biomarker for pain symptoms in the lower limbs in patients with DCM.