Advanced glycation end-products: a review

Advanced glycation end-products are a complex and heterogeneous group of co mpounds that have been implicated in diabetes related complications. At pre sent it is not known if they are the cause or the consequence of the compli cations observed. We discuss the chemistry of advanced glycated end-product formation and their patho-biochemistry particularly in relation to the dia betic microvascular complications of retinopathy, neuropathy and nephropath y as well as their role in the accelerated vasculopathy observed in diabete s. The concept of carbonyl stress as a cause for advanced glycated end-prod uct toxicity is mentioned. We discuss alterations in the concentrations of advanced glycated end-products in the body, particularly in relation to cha nges occuring with age, diabetes and its complications such as nephropathy. Problems relating to current methods of advanced glycated end-product dete ction and measurement are highlighted including the lack of a universally e stablished method of detection or unit of measurement. Agents used for the treatment of advanced glycated end-product accumulation are reviewed, with an emphasis on the results of the recent phase III trials using aminoguanid ine and diabetes related complications.