Increased serum concentrations of advanced glycation end products: a marker of coronary artery disease activity in type 2 diabetic patients

Objective-To assess whether the concentrations of serum advanced glycation end products (AGE) in diabetic patients with obstructive coronary artery di sease differ from those in type 2 diabetic patients without obstructive cor onary artery disease. Design-Serum AGE concentrations were measured in type 2 diabetic patients a nd in non-diabetic patients, both with and without obstructive coronary art ery disease, and the relation between these values and coronary disease sev erity was evaluated. Results-Mean (SD) serum AGE concentrations were higher (p < 0.0125) in type 2 diabetic patients with obstructive coronary artery disease (5.5 (2.5) mU /ml, n = 30) than in patients without obstructive coronary artery disease ( 2.8 (0.5) mU/ml, n = 12), and higher than in non diabetic patients with (3. 4 (1.0) mU/ml, n = 28) and without (3.2 (0.4) mU/ml, n = 13) obstructive co ronary artery disease. Serum AGE was associated with the degree of coronary arteriosclerosis in type 2 diabetic patients with obstructive coronary art ery disease (single vessel: n = 13, 3.4 (0.9) mU/m; two vessel: n = 6, 5.7 (1.6) mU/m; three vessel: n = 11, 7.2 (2.5) mU/ml). Serum AGE was positivel y correlated with serum mean four year HbA(1C) (r = 0.46, p < 0.01), but no t with recent serum HbA(1C) (r = 0.24). The four groups did not differ in t he other coronary risk factors. Conclusions-Serum AGE concentrations may be associated with long term poor glycaemic control and reflect the severity of coronary arteriosclerosis in type 2 diabetic patients.