title: Plasma protein advanced glycation end products, carboxymethyl cysteine, and carboxyethyl cysteine, are elevated and related to nephropathy in patients with diabetes.
abstract: In Diabetes Mellitus (DM), glucose and the aldehydes glyoxal and methylglyoxal modify free amino groups of lysine and arginine of proteins forming advanced glycation end products (AGEs). Elevated levels of these AGEs are implicated in diabetic complications including nephropathy. Our objective was to measure carboxymethyl cysteine (CMC) and carboxyethyl cysteine (CEC), AGEs formed by modification of free cysteine sulfhydryl groups of proteins by these aldehydes, in plasma proteins of patients with diabetes, and investigate their association with the albumin creatinine ratio (ACR, urine albumin (mg)/creatinine (mmol)), an indicator of nephropathy. Blood was collected from forty-two patients with type 1 and 2 diabetes (18-36 years) and eighteen individuals without diabetes (17-35 years). A liquid chromatography-mass spectrophotometric method was developed to measure plasma protein CMC and CEC levels. Values for ACR and hemoglobin A1C (HbA1C) were obtained. Mean plasma CMC (microg/l) and CEC (microg/l) were significantly higher in DM (55.73 +/- 29.43, 521.47 +/- 239.13, respectively) compared to controls (24.25 +/- 10.26, 262.85 +/- 132.02, respectively). In patients with diabetes CMC and CEC were positively correlated with ACR, as was HbA1C. Further, CMC or CEC in combination with HbA1C were better predictors of nephropathy than any one of these variables alone. These results suggest that glucose, glyoxal, and methylglyoxal may all be involved in the etiology of diabetic nephropathy.
authors.affiliation: Department of Laboratory Medicine, Memorial University, A1B 3V6, St. John's, NL, Canada.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Mostafa
authors.forename: Edward W
authors.initials: EW
authors.lastname: Randell
authors.forename: Sudesh C
authors.initials: SC
authors.lastname: Vasdev
authors.forename: Vicki D
authors.initials: VD
authors.lastname: Gill
authors.forename: Yingchun
authors.initials: Y
authors.lastname: Han
authors.forename: Vereesh
authors.initials: V
authors.lastname: Gadag
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Raouf
authors.forename: Hala
authors.initials: H
authors.lastname: El Said
mesh_terms: D000293:Adolescent; D000328:Adult; D000447:Aldehydes / Q000737:chemistry; D001798:Blood Proteins / Q000378:metabolism*; D002233:Carbocysteine / Q000031:analogs & derivatives* / Q000097:blood*; D003404:Creatinine; D003928:Diabetic Nephropathies / Q000097:blood*; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006037:Glyoxal / Q000737:chemistry; D006801:Humans; D008297:Male; D012709:Serum Albumin; D013438:Sulfhydryl Compounds / Q000378:metabolism
chemical_list: D000447:Aldehydes; D001798:Blood Proteins; D017127:Glycation End Products, Advanced; D012709:Serum Albumin; D013438:Sulfhydryl Compounds; C052226:S-(1-carboxyethyl)cysteine; D006037:Glyoxal; D002233:Carbocysteine; D003404:Creatinine