Assessment of Advanced Glycation Endproducts in Offspring of Type 2 Diabetes

Background Diabetes is a group of metabolic diseases characterized by hyperglycemia, There are several, well researched theories of how chronic hyperglycemia can lead to micro or macrovascular disease in diabetes including the advanced glycation end products (AGEs) theory. pentosidine is one of the best chemically characterized AGEs in humans pentosidine levels were significantly increased in diabetic patients with retinopathy and in diabetic patients with nephropathy. Aim of the work This study is designed to identify any changes of the level of AGEs in offspring of type 2 diabetes with and without impaired glucose tolerance and its relation to age, body mass index and various metabolic parameters in those subjects. Subjects Case control study was carried out On 66 volunteers subjects. And were divided into two main groups which were age, sex matched Group A Control group, includes 33 apparently healthy subjects. Group B Includes 33 non diabetic offspring of type 2 diabetic patients of whom one or both parents are diabetic which were further subdivided into 2 subgroups according to oral glucose tolerance test into i) Subgroup B1 Non diabetic normal glucose tolerant offspring, includes 16 healthy subjects. ii) Subgroup B2 Non diabetic impaired glucose tolerant offspring, includes 17 healthy offspring subjects. Methods all subjects of study were subjected to full history and thorough clinical examination, routine investigation as urine analysis, complete blood picture, liver and renal function tests oral glucose tolerance test, lipid profile. And specific investigation included measurement of fasting insulin and serum pentosidine by ELISA technique, and calculation of insulin resistance by HOMA index. Results There is significant increase in serum pentosidine level in group B2 in comparison to group A and group B1while there is no significant difference in this risk factor between Group A and Group B1. There is significant positive correlation between serum pentosidine level and each of fasting insulin level and HOMA-IR in group B2. While there was no significant correlation between pentosidine and each of age, Smoking status, BMI, waist circumference, cholesterol, triglycerides, FBG and 2hr postprandial blood glucose in group B1and groupB2. Conclusion the high level of serum pentosidine as an advanced glycation end product (AGE) in offspring of type 2 diabetes with impaired glucose tolerance may play a role in many vascular complications that occur before development of diabetes. Therefore we recommend screening offspring of type 2 diabetes for AGEs and early management to guard against vascular complications that may occur in the pre diabetic state.