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The relationship between treatment response and precursors of advanced glycation end-products in type 2 diabetes: a prospective case-control study

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Abstract

Background

In glycolysis, hydroxyl radicals emerge via the auto-oxidation pathway in a status of hyperglycemia, and by binding to proteins or lipids, form advanced glycation end-products (AGE). Glyoxal (GO) and methylglyoxal (MGO) are precursors of AGEs. The aim of this prospective, case-control study was to investigate the difference in levels of AGE precursors in patients with and without diabetes and to investigate the relationship between the change in rates of the AGE precursors and treatment in diabetic patients.

Methods

The study included 21 treatment-naive patients diagnosed with type 2 diabetes and 21 age and gender-matched healthy control subjects. Throughout an observation period of 3 months, the diabetic patients were started on anti-diabetic treatment and used no additional treatment or supplementary products. The GO and MGO levels were examined with the HPLC method.

Results

The GO and MGO levels were determined to be 1.74 and 0.024μg/mL respectively in the diabetic patients and 1.14 and 0.002 μg/mL in the control group. After 3 months of treatment, a statistically significant decrease compared to pre-treatment values was determined of 0.684 μg/mL in GO and 0.01989 μg/mL in MGO (p=0.001, p<0.01). No statistically significant relationship was determined between the change in HbA1c at 3 months compared to pre-treatment and the changes in GO and MGO (p>0.05).

Conclusion

The level of AGE precursors was found to be significantly higher in diabetic patients than in the healthy control group. Although there was a significant decrease in AGE precursors when the HbA1c level fell in patients who followed anti-diabetic treatment and diabetes-appropriate diet recommendations, this decrease was at different rates in each patient, which demonstrated that the HbA1c level is not the only determinant of AGE level in plasma. It can be concluded that with appropriate diet and antidiabetic treatment, significant reductions can be obtained in several risk factors which increase the level of AGE precursors.

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Authors and Affiliations

  1. Department of Biochemistry, University of Health Sciences, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Zuhuratbaba Mahallesi, Tevfik Saglam Caddesi, no:11, Bakirkoy, Istanbul, Turkey

    Isiksacan Nilgun & Kasapoglu Pinar

  2. Department of Immunology, University of Health Sciences, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Isiksacan Nilgun

  3. Department of Oncology, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Sahingoz Erdal Gulcin

  4. Department of Nutrition and Dietetics, Kutahya Health Sciences University, Kutahya, Turkey

    Ugur Halime

  5. Department of Nutrition and Dietetics, Sabahattin Zaim University, Istanbul, Turkey

    Yildirim Servi Esra

  6. Department of Cardiology, University of Health Sciences, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Karabulut Dilay

  7. Department of Internal Medicine, University of Health Sciences, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Kocamaz Nursel

  8. Department of Nutrition and Dietetics, Faculty of Health Sciences, Bolu Izzet Baysal University, I, Bolu, Turkey

    Yaman Mustafa

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  1. Isiksacan Nilgun
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  2. Sahingoz Erdal Gulcin
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Contributions

All authors contributed to the study conception and design, material preparation, data collection and analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Isiksacan Nilgun.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Bakirköy Sadi Konuk Training and Research Hospital (No:2019/312).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Nilgun, I., Gulcin, S.E., Pinar, K. et al. The relationship between treatment response and precursors of advanced glycation end-products in type 2 diabetes: a prospective case-control study. Int J Diabetes Dev Ctries 43, 99–104 (2023). https://doi.org/10.1007/s13410-022-01057-4

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  • DOI: https://doi.org/10.1007/s13410-022-01057-4

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