DIMINISHED ARTERIAL ELASTICITY IN DIABETES - ASSOCIATION WITH FLUORESCENT ADVANCED GLYCOSYLATION END-PRODUCTS IN COLLAGEN

Objective: Non-enzymatic glycosylation of proteins occurs in diabetes and advanced glycosylated end products can accumulate in long lived pr oteins such as vascular collagen and reduce the elasticity of vessel w alls. To evaluate the potential association of advanced glycosylated e nd products in collagen with diminished arterial elasticity in diabete s, 14 diabetic and 14 age and sex matched non-diabetic patients with c oronary artery disease were studied. Methods: Arterial elasticity was assessed in terms of carotid to femoral pulse wave velocity and by mea suring the change in ascending aortic diameter induced by pulse pressu re. Collagen linked fluorescence, a measure of advanced glycosylated e nd products, was determined from tissue specimens of the skin, ascendi ng aorta, and right atrial appendage taken during coronary bypass surg ery. Results: As a sign of diminished arterial elasticity, carotid to femoral pulse wave velocity was raised (p<0.01) and change in ascendin g aortic diameter tended to be diminished (p=0.09) in the diabetic pat ients. Collagen linked fluorescence was increased (p<0.05) in the myoc ardium of the diabetic group, but the difference in skin and aorta was not significant. Collagen linked fluorescence between the aorta, skin , and myocardium correlated with each other (r=0.64-0.77). Collagen li nked fluorescence in the aorta and myocardium correlated with carotid to femoral pulse wave velocity (r=0.63 and r=0.67, respectively) in th e diabetic group but not in the control group. Conclusions: These data suggest that non-enzymatic glycosylation of matrix proteins, and spec ifically collagen, may modify arterial elasticity in diabetic patients with coronary artery disease.