Beisswenger P J, Moore L L, Brinck-Johnsen T, Curphey T J
Department of Medicine, Dartmouth Medical School, Hanover, New Hampshire 03755.
J Clin Invest. 1993 Jul;92(1):212-7. doi: 10.1172/JCI116552.
Advanced glycosylation end products (AGEs) may play an important role in the development of diabetic vascular sequelae. An AGE cross-link, pentosidine, is a sensitive and specific marker for tissue levels of AGEs.
To evaluate the role of AGEs in the development of diabetic nephropathy and retinopathy, we studied pentosidine levels and the clinical characteristics of 48 subjects with insulin-dependent diabetes mellitus. Diabetic nephropathy was classified as normal, microalbuminuria, or gross proteinuria, and retinopathy was graded as none, background, or proliferative. NEWLY OBSERVED FINDINGS: Significant elevation of pentosidine (P = 0.025) was found in subjects with microalbuminuria or gross proteinuria (73.03 +/- 9.47 vs 76.46 +/- 6.37 pmol/mg col) when compared with normal (56.96 +/- 3.26 pmol/mg col). Multivariate analysis to correct for age, duration of diabetes, and gender did not modify the results. Elevated pentosidine levels were also found in those with proliferative when compared with those with background retinopathy (75.86 +/- 5.66 vs 60.42 +/- 5.98 pmol/mg col) (P < 0.05).
Microalbuminuria is associated with elevated levels of pentosidine similar to those found in overt diabetic nephropathy suggesting that elevated AGE levels are already present during the earliest detectable phase of diabetic nephropathy.
晚期糖基化终末产物（AGEs）可能在糖尿病血管并发症的发生发展中起重要作用。一种AGE交联物，戊糖苷，是组织中AGEs水平的敏感且特异的标志物。
为了评估AGEs在糖尿病肾病和视网膜病变发生发展中的作用，我们研究了48例胰岛素依赖型糖尿病患者的戊糖苷水平及临床特征。糖尿病肾病分为正常、微量白蛋白尿或大量蛋白尿，视网膜病变分为无、背景性或增殖性。新观察到的结果：与正常组（56.96±3.26 pmol/mg col）相比，微量白蛋白尿或大量蛋白尿患者的戊糖苷水平显著升高（P = 0.025）（73.03±9.47 vs 76.46±6.37 pmol/mg col）。校正年龄、糖尿病病程和性别后的多因素分析并未改变结果。与背景性视网膜病变患者相比，增殖性视网膜病变患者的戊糖苷水平也升高（75.86±5.66 vs 60.42±5.98 pmol/mg col）（P < 0.05）。
微量白蛋白尿与戊糖苷水平升高相关，类似于显性糖尿病肾病患者，提示在糖尿病肾病最早可检测阶段AGE水平就已升高。
