title: Liquid chromatography-based determination of urinary free and total N(epsilon)-(carboxymethyl)lysine excretion in normal and diabetic subjects.
abstract: We propose a specific, reproducible and sensitive HPLC method for the determination of N(epsilon)-(carboxymethyl)lysine (CML) excreted in urine. Total CML was measured in acid hydrolysates of urine samples, while free CML was measured in acetonitrile-deproteinised urine samples using a RP-HPLC method with ortho-phtaldialdehyde (OPA)-derivatisation and fluorescence detection suited for automation. We compared the CML excretion of 51 non-proteinuric patients with diabetes mellitus (DM) (age 57+/-14 years, HbA1c 8.0+/-1.8%) to 42 non-diabetic controls (C) (age 45+/-17 years). The urinary excretion of total CML in diabetic patients was increased by approximately 30% (DM: 0.58+/-0.21; C: 0.45+/-0.14 microM/mmol creatinine; P<0.001). While urinary excretion of free CML was not significantly different, excretion of bound CML was increased (DM: 0.36+/-0.17; C: 0.27+/-0.14; P<0.05) in diabetic patients. CML excretion was correlated with protein and albumin excretion, but did not correlate with HbA1c, duration of DM or diabetic complications such as neuropathy or retinopathy. Furthermore, no age-dependent change of total CML excretion was found, while free CML excretion was lower in younger subjects. The specific and sensitive determination of CML by RP-HPLC of its OPA-derivative is well suited for automation and better than that of less defined glycoxidation products (AGEs).
authors.affiliation: Department of Medicine IV, University of Tuebingen, D-72076 Tuebingen, Germany. ulrich.friess@med.uni-tuebingen.de
authors.forename: Ulrich
authors.initials: U
authors.lastname: Friess
authors.forename: Michaela
authors.initials: M
authors.lastname: Waldner
authors.forename: Hans Guenther
authors.initials: HG
authors.lastname: Wahl
authors.forename: Rainer
authors.initials: R
authors.lastname: Lehmann
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Haring
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Voelter
authors.forename: Erwin
authors.initials: E
authors.lastname: Schleicher
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives* / Q000652:urine*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013050:Spectrometry, Fluorescence
chemical_list: D006442:Glycated Hemoglobin; D008239:Lysine; C048496:N(6)-carboxymethyllysine