Relationship of glycation, antioxidant status and oxidativestress to vascular endothelial damage in diabetes

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Abstract
Aims: To examine the inter‐relationships of various microvascular pathogenic mechanisms in diabetic patients.Methods: Patients with diabetes (n = 18) and non‐diabetic subjects (n = 18) were studied.Results: Blood markers of glycaemic control and glycation differed between the two groups (glucose 10.9 ± 7.6 vs. 4.7 ± 0.63 mmol/l, p < 0.01; HbA1c 7.0 ± 1.3 vs. 4.5 ± 0.3%, p < 0.001; glycated LDL 8.8 ± 2.5 vs. 6.1 ± 1.2%, p < 0.001) but plasma antioxidant status did not. LDL oxidation resistance, measured as lag time to maximum oxidation initiated by copper ions, was decreased in diabetes (58. ± 14.3 vs. 76.3 ± 21.5 min, p < 0.01). Both soluble intercellular adhesion molecule‐1 (ICAM‐1) and vascular cell adhesion molecule‐1 (VCAM‐1), markers of endothelial dysfunction, were significantly higher in diabetes (ICAM 491 ± 128 vs. 403 ± 131 µg/l, p < 0.05; VCAM 546 ± 157 vs. 393 ± 106 µg/l, p < 0.01). Linear correlations were significant between HbA1c and lag time of LDL oxidation (r = −0.39, p < 0.05), ICAM (r = 0.40, p < 0.05) and VCAM (r = 0.38, p < 0.05). LDL oxidizability correlated with vitamin C (r = 0.51, p < 0.01) but not any adhesion molecule. In multivariate analysis, both ICAM and VCAM correlated with HbA1c only (r2 = 0.16, F = 6.3, p < 0.01; r2 = 0.14, F = 5.4, p < 0.01 respectively).Conclusion: In diabetes, glycation, tissue oxidation and endothelial function are all abnormal and predisposing to microvascular complications but interrelationships are complex with glycation appearing most direct.

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