Advanced glycation end products in nondiabetic patients with coronary artery disease

OBJECTIVE - To investigate whether advanced glycation end products (AGEs) p articipate in the development of coronary artery disease (CAD) in nondiabet ic and diabetic subjects. RESEARCH DESIGN AND METHODS - Serum concentrations of AGEs were measured us ing a newly established enzyme-linked immunosorbent. assay in 48 nondiabeti c patients (normal glucose tolerance, n = 20; impaired glucose tolerance, n = 28) who received coronary angiography for the study of chest pain or sus pected CAD. Insulin sensitivity was examined by the euglycemic-hyperinsulin emic glucose clamp technique and was estimated as the mean glucose infusion rate during the last 30 min of clamp time (M value). RESULTS- Patients were classified into four groups based on the number of s ignificantly stenosed vessels, defined as 0-, 1-, 2-, or 3-vessel disease. Serum concentrations of AGEs were significantly higher in nondiabetic subje cts with CAD than in control subjects (2.42 +/- 0.65 vs. 1.96 +/- 0.40 mU/m l, P < 0.01) and significantly correlated with the number of significantly stenosed vessels (r = 0.678, P < 0.001). M values significantly inversely c orrelated with serum concentrations of AGEs (r = -0.490, P < 0.05). In mult iple regression analysis, with the number of significantly, stenosed Vessel s as the dependent variable, serum concentrations of AGEs. 2-h plasma gluco se, and areas under the plasma glucose response curve were independently as sociated. CONCLUSIONS - This pilot study indicates the relation between AGEs and the severity of CAD in nondiabetic patients. The measurement of serum AGE conce ntrations may be predictive of vascular damage.