ABSTRACT
Postprandial glucose and triglyceride increments after a mixed meal are more prolonged in people with type 1 and 2 diabetes or with impaired glucose tolerance than in normal individuals. Evidence in the literature suggests that these transient increases represent an additional and independent risk for chronic hyperglycemia to induce endothelial dysfunction, an important fact for the development of diabetic vascular complications. This article presents the more relevant mechanisms by which acute postprandial hyperglycemia and hyperlipidemia have been proved to determine the risk of reactive oxygen species overproduction, an increased synthesis of non enzymatic early-glycated and nitrated proteins, and a more atherogenic lipoprotein profile. Recent recommendations suggest that care for this transient glycoxidative stress should be associated with fasting glucose or HbA1c care, to reduce the risk of macro- and microvascular complications in people with diabetes.
Subject(s)
Diabetes Mellitus/etiology , Hyperglycemia/metabolism , Hyperlipidemias/metabolism , Oxidative Stress/physiology , Postprandial Period/physiology , Animals , Diabetes Mellitus/metabolism , Free Radicals , Humans , Hyperglycemia/complications , Hyperlipidemias/complicationsABSTRACT
Chronic hyperglycemia induces an increase in the non enzymatic glycation of circulating and structural proteins together with a glucose-generated oxidative and carbonyl stress, known as glycoxidation. The physicochemical characteristics and the metabolism of lipoproteins are altered by glycation/glycoxidation and resemble those of other body proteins, except for the fact that there is a simultaneous glycoxidation of both protein and phospholipid components generating an oxidative stress that increases lipoxidation. Information gathered during the last few years suggests that, among lipoproteins, modified LDL would principally contribute to developing diabetic micro-macrovascular complications. The control and the prevention of the progress of such complications are difficult to attain due to the irreversibility of glycoxidation. As glycation/glycoxidation is related to mean blood glucose, the goal in diabetes treatment must be the achievement of a close to normal metabolic control. This review summarizes advances in the importance of lipoprotein glycation/glycoxidation in diabetes mellitus.
Subject(s)
Diabetes Mellitus/metabolism , Glucose/metabolism , Lipoproteins/metabolism , Cardiovascular Diseases/prevention & control , Glycosylation , Humans , Hyperglycemia/complications , Lipoproteins, HDL/metabolism , Lipoproteins, LDL/metabolism , Lipoproteins, VLDL/metabolism , Oxidative Stress/physiologyABSTRACT
Chronic hyperglycemia induces an increase in the non enzymatic glycation of circulating and structural proteins together with a glucose-generated oxidative and carbonyl stress, known as glycoxidation. The physicochemical characteristics and the metabolism of lipoproteins are altered by glycation/glycoxidation and resemble those of other body proteins, except for the fact that there is a simultaneous glycoxidation of both protein and phospholipid components generating an oxidative stress that increases lipoxidation. Information gathered during the last few years suggests that, among lipoproteins, modified LDL would principally contribute to developing diabetic micro-macrovascular complications. The control and the prevention of the progress of such complications are difficult to attain due to the irreversibility of glycoxidation. As glycation/glycoxidation is related to mean blood glucose, the goal in diabetes treatment must be the achievement of a close to normal metabolic control. This review summarizes advances in the importance of lipoprotein glycation/glycoxidation in diabetes mellitus.
ABSTRACT
El objetivo de este estudio fue establecer en nuestra población valores de referencia para fructosamina en embarazadas normales durante el primero, segundo y tercer trimestre de gestación y en niños de primera (<1-6 años) y segunda (6-12) infancia. El límite superior de fructosamina (expresado como 97,5 percentilo) para adultos de nuestro medio (271 µmol/L) no difiere del hallado en estudios multicéntricos. En cambio son menores los límites de normalidad para embarazadas de segundo (231 µmo/L) y tercer (221 µmol/L) trimestre de embarazo, y niños de primera infancia (239 µmol/L). Lo mismo ocurre al expresar los valores normalizados por proteinemia. Exiten correlaciones inversas significativasentre la concentración de fructosamina y a) el progreso de la edad de gestación(r=0,64; p<0,001; n= 147), y b) el incremento de la edad en los niños de 0 a 12 años (r=0,63; p<0,001; n= 137). Estos resultados demuestran la necesidad de definir rangos de normalidad independientes para los adultos, los niños de primera infancia y las embarazadas de acuerdo a su edad de gestación
Subject(s)
Humans , Child , Pregnancy , FructosamineABSTRACT
El objetivo de este estudio fue establecer en nuestra población valores de referencia para fructosamina en embarazadas normales durante el primero, segundo y tercer trimestre de gestación y en niños de primera (<1-6 años) y segunda (6-12) infancia. El límite superior de fructosamina (expresado como 97,5 percentilo) para adultos de nuestro medio (271 Amol/L) no difiere del hallado en estudios multicéntricos. En cambio son menores los límites de normalidad para embarazadas de segundo (231 Amo/L) y tercer (221 Amol/L) trimestre de embarazo, y niños de primera infancia (239 Amol/L). Lo mismo ocurre al expresar los valores normalizados por proteinemia. Exiten correlaciones inversas significativasentre la concentración de fructosamina y a) el progreso de la edad de gestación(r=0,64; p<0,001; n= 147), y b) el incremento de la edad en los niños de 0 a 12 años (r=0,63; p<0,001; n= 137). Estos resultados demuestran la necesidad de definir rangos de normalidad independientes para los adultos, los niños de primera infancia y las embarazadas de acuerdo a su edad de gestación (AU)
