Products of advanced glycation in patients with type 2 diabetes and vascular disease

Ann Clin Biochem 2003;40:552-559
doi:10.1258/000456303322326489
© 2003 Association for Clinical Biochemistry

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Original Articles


Z Turk,
M Sesto,
J Skodlar,
G Ferencak,
R Pokupec,
N Turk and
A Stavljenicc-Rukavina


Vuk Vrhovac University Clinic for Diabetes, Zagreb University Hospital Centre, Croatia;
Magdalena Specialised Hospital for Cardiovascular Surgery and Cardiology, Zagreb University Hospital Centre, Croatia;
Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Centre, Croatia;
School of Medicine, University of Zagreb, Croatia;
Clinical Institute of Laboratory Diagnosis, Zagreb University Hospital Centre, Croatia


Background: Non-enzymatic glycation leading to advanced glycation endproduct (AGE) formation is thought to contribute to vascular pathology. In the present study, AGEs and anti-AGE antibodies in free and immune complex-bound form were assayed in the serum of diabetic (DMCAD) (n = 69) and nondiabetic (n = 78) patients with coronary artery disease (CAD) and in control subjects (n= 47) free from vascular disease.

Methods: A blocking enzyme-linked immunosorbent assay (ELISA)was used to test immunoreactivity against AGE epitope(s) anda competitive ELISA was used to measure total AGE content.

Results: Anti-AGE immunoreactivity was significantly higher in diabetic than in control subjects (P = 0.045). Although a wide range of anti-AGE antibody titres were observed in nondiabetic CAD patients, there was no significant difference from those of control subjects. Both diabetic and nondiabetic CAD patients had a higher concentration of circulating immune complexes containing the AGE moiety as antigen than did control subjects (DMCAD versus control, P = 0.041; CAD versus control, P = 0.047). Study patients showed a positive correlation between serum AGE and AGE-immune complexes (DM, r = 0.29, P = 0.014; CAD, r = 0.26, P = 0.019), whereas no such correlation was recorded in controls (r = 0.08, P = 0.89).

Conclusion: To our knowledge, this is the first study demonstratingincreased AGE-immune complexes in patients with CAD, eitherwith or without diabetes, suggesting that AGE-immune complexesmight be involved in the atherosclerotic process, either asthe result of it or as part of the pathophysiologic process.


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