| Glucose and other reducing sugars can react non - enzymatically with the a-mino groups of proteins to form reversible Schiff bases and then Amadori products. These early glycation products undergo further complex reactions such as rearrangement. Dehydration and condensation to become irreversibly crosslinked. Heterogeneous fluorescent derivatives termed advanced glycation endproducts ( AGEs ). The formation and accumulation of AGE in various tissues have been known to extend rapidly in chromic diabetes. This has been implicated in the development of the diabetic micro - and macrovascular complications, which may account for the disabilities and high mortality rate in patients with this disease.Several AGEs have been purified and structurally characterized so far, including N - ( carboxymethyl) lysine (CML), pentosidine and parraline Some of their tissue levels are associated with severity of diabetic microvascular complications.Material and methodsMaterialThe study involved patient with Type 2diabetes (22 male and 11 female) with a mean age of (61. 5 ± 7.5) years (mean SD)and know duration of diabetes of (6.5 ± 7.3 ) years with a current HbAlc of the WHO reported in 1999. Urinary albumin excretion ( UAE) was determined by radioimmunoassay using an anti - albumin antibody as described previously. Serum levels of AGE was measured with an enzymed - linked immunosorbent assay by using polyclonal antibod-ies agaist AGE - rabbit serum albumin. HbAlc was analyzed with high - performance liquid chromatography method that has a normal range of 4.3 -5.8% whith an interassay coefficient of variation of 5 - 8%.Statistical analysisDifferences between groups were tested using Fishers exact probability test for categorical variables. Pvalues under 5% were considered to indicate statistical significance. All analyses were performed with the personal computer statistics package SPSS for Windows version 10. 0 or Fisher for Windows version 1. 01. A stepwise logistical regression analysis was performed with diabetic ne-phropathy as the dependent variable.ResultsTable 1 shows the clinical characteristics of 33 patients with Type 2 diabetes nephropathy. We found that there were significant differences in current HbAlc level, serum creatinine There were significant correlations between serum levels of AGEs and surrent HbAl c ( r = 0.6374, P < 0.01, respectively ).Serum levels of AGEs were significantly increased as normal renal status advanced to diabetic nephropathy, (P <0. 001). In a stepwise logistic regression analysis with diabetic nephropathy as the dependent variables (including age, diabetic duration, serum AGEs as the indepentent variables ) , serum AGEs were significantly associated with the development of nephropathy.DiscussionWe found in the present study that serum levels of AGEs were significantly increased as normal renal status advanced to diabetic nephropathy in patients with Type 2 diabetes nephropathy In this study, we enrolled patients with each stage of diabetic nephropathy.It was reported that serum AGEs leves in diabetic patients were extremely higher than those without endstage renal disease, which is caused by renal clearance , In our data, each three different AGEs in diabetic patients were also ex-tremely higher than those without endstage renal disease. It was notable that there was a significant difference in serum AGEs levels between the no ne-phrophathy and microalbuminuria groups, which was the initial stage of diabetic nephropathy. Since chronic treatment of AGE - BSA was reported to induce glo-merular sclerosis and albuminuria in normal rats. In our study, observation sug-gest that tissue but not serum glocoxidation products maybe markers of develop-ment of diabetic nephropathy.It is difficult to explain the occurrence and development of diabetic vascular complications, there were some cases closed to normal AGEs levels. However, its tendency was coincident with the result of stepwise logistic regression analy-sis. In the present study, serum levels of...
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