MAILLARD REACTION-PRODUCTS AND THEIR RELATION TO COMPLICATIONS IN INSULIN-DEPENDENT DIABETES-MELLITUS
MAILLARD REACTION-PRODUCTS AND THEIR RELATION TO COMPLICATIONS IN INSULIN-DEPENDENT DIABETES-MELLITUS
复制标题
DOI：
10.1172/jci116482
复制
发表时间：
1993-06-01
影响因子：
15.9
通讯作者：
LYONS, TJ
中科院分区：
文献类型：
--
作者：
MCCANCE, DR;DYER, DG;LYONS, TJ
蛋白质的糖化、氧化和布朗宁都与糖尿病并发症的发生有关。我们测量了初始Amadori加合物果糖赖氨酸（FL）;两种美拉德产物，N（N）-N（OH）。（羧甲基）赖氨酸（CML）和戊糖苷;和（激发= 328 nm，发射= 378 nm），来自39名1型糖尿病患者的皮肤胶原蛋白（年龄41.5 ± 15.3 117-731岁;糖尿病病程17.9 ± 11.5 10-461岁，[平均值+/- SD，范围]）。测量结果与背景（n = 9）或增殖性（n = 16）视网膜病变、早期肾病（24小时白蛋白排泄率[AER 24]大于或等于20 mug/min; n = 9）和关节活动受限（LJM; n = 20）相关。FL、CML、戊糖苷酶和荧光在糖尿病视网膜病变中进行性增加（分别为P < 0.05、P < 0.001、P < 0.05、P < 0.01）。早期肾病患者FL、CML、戊糖苷酶和荧光素水平也升高（分别为P < 0.05、P < 0.001、P < 0.01、P < 0.01）。与解放运动没有关联。使用逻辑回归控制年龄、性别和糖尿病病程，FL和CML与视网膜病变独立相关（FL比值比（OR）= 1.06，95%置信区间（CI）= 1.011）。早期肾病（FL OR = 1.05，95%CI = 1.01-1.10，P <0.05; CML OR = 6.77，95%CI = 1.33-34.56，P <0.05）和慢性粒细胞白血病（CML）OR = 13.44，95%CI = 2.0093。30，P < 0.01）。荧光与视网膜病变、戊糖苷与肾病的相关性接近显著性（P = 0.05）。这些数据表明，皮肤中的FL和美拉德产物与其他组织中的功能异常相关，并表明蛋白质糖化和氧化（糖氧化）可能与糖尿病视网膜病变和早期肾病的发展有关。
Glycation, oxidation, and browning of proteins have all been implicated in the development of diabetic complications. We measured the initial Amadori adduct, fructoselysine (FL); two Maillard products, N(epsilon)-(carboxymethyl) lysine (CML) and pentosidine; and fluorescence (excitation = 328 nm, emission = 378 nm) in skin collagen from 39 type 1 diabetic patients (aged 41.5 +/- 15.3 117-731 yr; duration of diabetes 17.9 +/- 11.5 10-461 yr, [mean +/- SD, range]). The measurements were related to the presence of background (n = 9) or proliferative (n = 16) retinopathy; early nephropathy (24-h albumin excretion rate [AER24] greater-than-or-equal-to 20 mug/min; n = 9); and limited joint mobility (LJM; n = 20). FL, CML, pentosidine, and fluorescence increased progressively across diabetic retinopathy (P < 0.05, P < 0.001, P < 0.05, P < 0.01, respectively). FL, CML, pentosidine, and fluorescence were also elevated in patients with early nephropathy (P < 0.05, P < 0.001, P < 0.01, P < 0.01, respectively). There was no association with LJM. Controlling for age, sex, and duration of diabetes using logistic regression, FL and CML were independently associated with retinopathy (FL odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.011. 12, P < 0.05; CML OR = 6.77, 95% CI = 1.33-34.56, P < 0.05) and with early nephropathy (FL OR = 1.05, 95% CI = 1.01-1.10, P < 0.05; CML OR = 13.44,95% CI = 2.0093. 30, P < 0.01). The associations between fluorescence and retinopathy and between pentosidine and nephropathy approached significance (P = 0.05). These data show that FL and Maillard products in skin correlate with functional abnormalities in other tissues and suggest that protein glycation and oxidation (glycoxidation) may be implicated in the development of diabetic retinopathy and early nephropathy.