MINIREVIEW
Advanced Glycation End-Products and the
Progress of Diabetic Vascular Complications
V. JAKUŠ, N. RIETBROCK1
Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry,
Faculty of Medicine, Comenius University, Bratislava, Slovak Republic and
1Department of Clinical Pharmacology, Johann Wolfgang Goethe
University, Frankfurt/Main, Germany
Received January 17, 2003
Accepted June 9, 2003
Summary
Epidemiological studies have confirmed that hyperglycemia is the most
important factor in the onset and progress of vascular complications, both
in Type 1 and 2 diabetes mellitus. The formation of advanced glycation
end-products (AGEs) correlates with glycemic control. The AGE hypothesis
proposes that accelerated chemical modification of proteins by glucose
during hyperglycemia contributes to the pathogenesis of diabetic
complications including nephropathy, retinopathy, neuropathy and
atherosclerosis. Recent studies have shown that increased formation of
serum AGEs exists in diabetic children and adolescents with or without
vascular complications. Furthermore, the presence of diabetic
complications in children correlates with elevated serum AGEs. The level
of serum AGEs could be considered as a marker of later developments of
vascular complications in children with Type 1 and 2 diabetes mellitus.
The careful metabolic monitoring of young diabetics together with
monitoring of serum AGEs can provide useful information about impending
AGE-related diabetic complications. It is becoming clear that anti-AGE
strategies may play an important role in the treatment of young and older
diabetic patients. Several potential drug candidates such as AGE
inhibitors have been reported recently.
Key words
Diabetic vascular complications • Hyperglycemia • Advanced glycation
end-products • Oxidative stress • Inhibitors of glycation
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