Sell D R, Lapolla A, Odetti P, Fogarty J, Monnier V M
Institute of Pathology, Case Western Reserve University, Cleveland, Ohio 44106.
Diabetes. 1992 Oct;41(10):1286-92. doi: 10.2337/diab.41.10.1286.
Pentosidine is an advanced glycosylation end product and protein cross-link that results from the reaction of pentoses with proteins. Recent data indicate that long-term glycation of proteins with glucose also leads to pentosidine formation through sugar fragmentation. In this study, the relationship between the severity of diabetic complications and pentosidine formation was investigated in collagen from skin-punch biopsies from 25 nondiabetic control subjects and 41 IDDM patients with diabetes duration greater than 17 yr. Pentosidine was significantly elevated in all IDDM patients versus control subjects (P less than 0.0001). It correlated strongly with age (P less than 0.0001) and weakly with duration (P less than 0.082). Age-adjusted pentosidine levels were highest in grade 2 (severe) versus grade 1 and 0 complication in all four parameters tested (retinopathy, proteinuria, arterial stiffness, and joint stiffness). Significant differences were found for retinopathy (P less than 0.014) and joint stiffness (P less than 0.041). The highest degree of association was with the cumulative grade of individual complication (P less than 0.005), determined by summing indexes of all four parameters. Pentosidine also was significantly elevated in the serum of IDDM patients compared with control subjects (P less than 0.0001), but levels were not significantly correlated with age, diabetes duration, complication, or skin collagen pentosidine (P greater than 0.05). A high correlation between pentosidine levels and long-wave collagen-linked fluorescence also was observed, suggesting that pentosidine is a generalized marker of accelerated tissue modification by the advanced glycosylation/Maillard reaction, which is enhanced in IDDM patients with severe complications.
戊糖苷是一种晚期糖基化终产物和蛋白质交联物，由戊糖与蛋白质反应产生。最近的数据表明，蛋白质与葡萄糖的长期糖化作用也会通过糖片段化导致戊糖苷的形成。在本研究中，对25名非糖尿病对照受试者和41名糖尿病病程超过17年的胰岛素依赖型糖尿病（IDDM）患者的皮肤穿刺活检组织中的胶原蛋白进行研究，以探讨糖尿病并发症的严重程度与戊糖苷形成之间的关系。与对照受试者相比，所有IDDM患者的戊糖苷水平均显著升高（P<0.0001）。它与年龄密切相关（P<0.0001），与病程的相关性较弱（P<0.082）。在所有四个测试参数（视网膜病变、蛋白尿、动脉僵硬度和关节僵硬度）中，年龄校正后的戊糖苷水平在2级（严重）并发症患者中最高，高于1级和0级并发症患者。视网膜病变（P<0.014）和关节僵硬度（P<0.041）存在显著差异。关联程度最高的是个体并发症的累积等级（P<0.005），通过将所有四个参数的指标相加来确定。与对照受试者相比，IDDM患者血清中的戊糖苷水平也显著升高（P<0.0001），但水平与年龄、糖尿病病程、并发症或皮肤胶原蛋白戊糖苷均无显著相关性（P>0.05）。还观察到戊糖苷水平与长波胶原蛋白相关荧光之间存在高度相关性，这表明戊糖苷是晚期糖基化/美拉德反应加速组织修饰的一个普遍标志物，在患有严重并发症的IDDM患者中这种反应增强。
