Serum concentrations of advanced glycation endproducts are associated withthe development of atherosclerosis as well as diabetic microangiopathy in patients with type 2 diabetes

We measured serum concentrations of advanced glycation endproducts (AGEs) i n patients with type 2 diabetes, to elucidate the mechanisms underlying the elevated serum concentrations of AGEs and to clarify the relationship betw een serum AGE concentrations and the development of microangiopathy and mac roangiopathy. Serum AGEs were significantly higher in diabetic patients tha n in age-matched control subjects (p < 0.0001). In diabetic patients, serum AGEs were positively correlated with HbAlc (r = 0.47, p < 0.0001), urinary albumin excretion (UAE) (r = 0.42, p < 0.0001), diabetes duration (r = 0.3 1, p = 0.0030), and fasting plasma glucose (r = 0.34, p 0.0010). Multiple r egression analysis disclosed that only the KbAlc and UAE levels independent ly correlated with serum AGE levels. Serum AGEs in diabetic patients with p rogressive retinopathy and overt nephropathy were significantly higher than in those with less severe retinopathy and nephropathy. Serum AGEs were sig nificantly higher in the diabetic patients with coronary heart disease (CHD ) than in those without CHD. These results suggest that the HbAlc and UAE l evels are independent risk factors for increased serum AGE concentrations i n type 2 diabetic patients, and that higher serum AGE concentrations are as sociated with increased severity of diabetic retinopathy and nephropathy. S erum AGE concentrations may be a useful marker not only for the severity of diabetic microangiopathy but also for the development of CHD in patients w ith type 2 diabetes mellitus.