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Role of N-(carboxymethyl)lysine in the development of ischemic heart disease in type 2 diabetes mellitus.

A Ahmed K, Muniandy S, S Ismail I - J Clin Biochem Nutr (2007)

Bottom Line: Serum CML levels were measured by enzyme-linked immunosorbent assay using polyclonal anti-CML antibodies.In conclusion, this study demonstrates the effect of both diabetes and oxidative stress on the higher levels of circulating CML.These results showed that increased serum levels of CML are associated with the development of IHD in Type 2 diabetes mellitus.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

ABSTRACT
This study aims to determine the levels of N(epsilon)-(carboxymethyl)lysine (CML) in patients with Type 2 diabetic patients with and without ischemic heart disease (IHD) and to find for a possible association between circulating CML and a number of clinical parameters including lipids, hemoglobin A1c (HbA1c) and malondialdehyde (MDA) in Type 2 diabetic IHD patients. Serum CML levels were measured by enzyme-linked immunosorbent assay using polyclonal anti-CML antibodies. Serum levels of CML and MDA were assessed in 60 IHD patients with Type 2 diabetes, 43 IHD patients without Type 2 diabetes, 64 Type 2 diabetics without IHD, and 80 sex- and age-matched healthy subjects. Correlations studies between CML levels and lipids, HbA1c, and lipid peroxidation were performed in Type 2 diabetes patients with and without IHD. A statistical significance was observed in the levels of serum glucose, lipids (triglyceride, total cholesterol, HDL-cholesterol), MDA, HbA1c, CML and LDL-cholesterol (p<0.05) between the groups of the study. CML levels were significantly increased in diabetic IHD patients compared with Type 2 diabetes patients but without IHD (537.1 +/- 86.1 vs 449.7 +/- 54.9, p<0.001). A positive correlation was observed between serum levels of CML and MDA, r = 0.338 (p = 0.008) in Type 2 diabetes patients with IHD. However, age, HbA1c and lipids had no significant influence on CML levels among diabetics (p>0.05). In conclusion, this study demonstrates the effect of both diabetes and oxidative stress on the higher levels of circulating CML. These results showed that increased serum levels of CML are associated with the development of IHD in Type 2 diabetes mellitus.

No MeSH data available.


Related in: MedlinePlus

Concentrations of Nε-(carboxymethy)lysine (CML) in the study groups. Data represent means ± SD. **p<0.001 versus healthy controls, IHD patients without Type 2 diabetes, and Type 2 diabetics without IHD.
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Figure 3: Concentrations of Nε-(carboxymethy)lysine (CML) in the study groups. Data represent means ± SD. **p<0.001 versus healthy controls, IHD patients without Type 2 diabetes, and Type 2 diabetics without IHD.

Mentions: Table 1 shows the clinical characteristics of the study groups. The study populations were well matched for age and gender with their respective control groups. The mean ages in these groups, healthy control subjects, Type 2 diabetes patients with IHD, IHD patients without Type 2 diabetes, and Type 2 diabetics without IHD were 44.0 ± 14.0, 43.7 ± 14.9, 48.4 ± 18.1, and 45.2 ± 17.1 years respectively and the age difference between these groups was not significant (p = 0.48). The four groups were comparable with respect to gender as tested by Chi-square (p = 0.56). When the four groups were compared, a statistical significance was observed in the levels of serum fasting blood glucose, lipids (triglyceride, total cholesterol, HDL-cholesterol), MDA, HbA1c and CML, and to a lesser extent in LDL-cholesterol. Fig. 3 shows that CML levels were markedly higher in diabetics with IHD when compared to other groups of the study. There was no significant difference in systolic blood pressure and diastolic blood pressure among the study groups. For all variables in the study groups that showed statistical significance by analysis of variance, post-hoc comparisons of means were made using the Bonferroni test. Clinical parameters were also compared between diabetic patients (Type 2 diabetes with and without IHD) groups. The durations of diabetes in the Type 2 diabetics with IHD and without IHD were 9.3 ± 4.0 and 9.9 ± 5.0 years respectively. Although triglyceride levels were significantly higher in Type 2 diabetes patients with IHD than diabetics without IHD (p = 0.007), all lipid profiles including total cholesterol, HDL-cholesterol and LDL-cholesterol were not significant. The difference in the fasting blood glucose levels was not significant between diabetic patients groups. However, patients with Type 2 diabetes and IHD had significantly higher levels of MDA and CML levels than diabetic patients without IHD; 2.73 ± 1.01 vs 2.21 ± 0.72, p = 0.001 and 537.1 ± 86.1 vs 449.7 ± 54.9, p<0.001, respectively (Table 1). Correlation studies showed that serum CML levels in Type 2 diabetes with IHD were positively and significantly correlated with MDA (r = 0.338, p = 0.008) (Fig. 4A) and such correlations were not found between the serum levels of CML and age (r = 0.168, p = 0.19), HbA1c (r = 0.067, p = 0.61) and LDL- cholesterol (r = –0.097, p = 0.46). However, MDA was not correlated with the CML concentrations in Type 2 diabetes but without IHD (r = 0.035, p = 0.78) (Fig. 4B).


Role of N-(carboxymethyl)lysine in the development of ischemic heart disease in type 2 diabetes mellitus.

A Ahmed K, Muniandy S, S Ismail I - J Clin Biochem Nutr (2007)

Concentrations of Nε-(carboxymethy)lysine (CML) in the study groups. Data represent means ± SD. **p<0.001 versus healthy controls, IHD patients without Type 2 diabetes, and Type 2 diabetics without IHD.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2170948&req=5

Figure 3: Concentrations of Nε-(carboxymethy)lysine (CML) in the study groups. Data represent means ± SD. **p<0.001 versus healthy controls, IHD patients without Type 2 diabetes, and Type 2 diabetics without IHD.
Mentions: Table 1 shows the clinical characteristics of the study groups. The study populations were well matched for age and gender with their respective control groups. The mean ages in these groups, healthy control subjects, Type 2 diabetes patients with IHD, IHD patients without Type 2 diabetes, and Type 2 diabetics without IHD were 44.0 ± 14.0, 43.7 ± 14.9, 48.4 ± 18.1, and 45.2 ± 17.1 years respectively and the age difference between these groups was not significant (p = 0.48). The four groups were comparable with respect to gender as tested by Chi-square (p = 0.56). When the four groups were compared, a statistical significance was observed in the levels of serum fasting blood glucose, lipids (triglyceride, total cholesterol, HDL-cholesterol), MDA, HbA1c and CML, and to a lesser extent in LDL-cholesterol. Fig. 3 shows that CML levels were markedly higher in diabetics with IHD when compared to other groups of the study. There was no significant difference in systolic blood pressure and diastolic blood pressure among the study groups. For all variables in the study groups that showed statistical significance by analysis of variance, post-hoc comparisons of means were made using the Bonferroni test. Clinical parameters were also compared between diabetic patients (Type 2 diabetes with and without IHD) groups. The durations of diabetes in the Type 2 diabetics with IHD and without IHD were 9.3 ± 4.0 and 9.9 ± 5.0 years respectively. Although triglyceride levels were significantly higher in Type 2 diabetes patients with IHD than diabetics without IHD (p = 0.007), all lipid profiles including total cholesterol, HDL-cholesterol and LDL-cholesterol were not significant. The difference in the fasting blood glucose levels was not significant between diabetic patients groups. However, patients with Type 2 diabetes and IHD had significantly higher levels of MDA and CML levels than diabetic patients without IHD; 2.73 ± 1.01 vs 2.21 ± 0.72, p = 0.001 and 537.1 ± 86.1 vs 449.7 ± 54.9, p<0.001, respectively (Table 1). Correlation studies showed that serum CML levels in Type 2 diabetes with IHD were positively and significantly correlated with MDA (r = 0.338, p = 0.008) (Fig. 4A) and such correlations were not found between the serum levels of CML and age (r = 0.168, p = 0.19), HbA1c (r = 0.067, p = 0.61) and LDL- cholesterol (r = –0.097, p = 0.46). However, MDA was not correlated with the CML concentrations in Type 2 diabetes but without IHD (r = 0.035, p = 0.78) (Fig. 4B).

Bottom Line: Serum CML levels were measured by enzyme-linked immunosorbent assay using polyclonal anti-CML antibodies.In conclusion, this study demonstrates the effect of both diabetes and oxidative stress on the higher levels of circulating CML.These results showed that increased serum levels of CML are associated with the development of IHD in Type 2 diabetes mellitus.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

ABSTRACT
This study aims to determine the levels of N(epsilon)-(carboxymethyl)lysine (CML) in patients with Type 2 diabetic patients with and without ischemic heart disease (IHD) and to find for a possible association between circulating CML and a number of clinical parameters including lipids, hemoglobin A1c (HbA1c) and malondialdehyde (MDA) in Type 2 diabetic IHD patients. Serum CML levels were measured by enzyme-linked immunosorbent assay using polyclonal anti-CML antibodies. Serum levels of CML and MDA were assessed in 60 IHD patients with Type 2 diabetes, 43 IHD patients without Type 2 diabetes, 64 Type 2 diabetics without IHD, and 80 sex- and age-matched healthy subjects. Correlations studies between CML levels and lipids, HbA1c, and lipid peroxidation were performed in Type 2 diabetes patients with and without IHD. A statistical significance was observed in the levels of serum glucose, lipids (triglyceride, total cholesterol, HDL-cholesterol), MDA, HbA1c, CML and LDL-cholesterol (p<0.05) between the groups of the study. CML levels were significantly increased in diabetic IHD patients compared with Type 2 diabetes patients but without IHD (537.1 +/- 86.1 vs 449.7 +/- 54.9, p<0.001). A positive correlation was observed between serum levels of CML and MDA, r = 0.338 (p = 0.008) in Type 2 diabetes patients with IHD. However, age, HbA1c and lipids had no significant influence on CML levels among diabetics (p>0.05). In conclusion, this study demonstrates the effect of both diabetes and oxidative stress on the higher levels of circulating CML. These results showed that increased serum levels of CML are associated with the development of IHD in Type 2 diabetes mellitus.

No MeSH data available.


Related in: MedlinePlus