Advanced glycation end products are associated with pulse pressure in type 1 diabetes - The EURODIAB Prospective Complications Study

We investigated the associations of pulse pressure ( a measure of arterial stiffness) with the early glycation products hemoglobin A1c (HbA1c) and Amadori albumin and the advanced glycation end products pentosidine, N-epsilon( carboxymethyl) lysine and N-epsilon- ( carboxyethyl) lysine in a large group of type 1 diabetic individuals of the EURODIAB Prospective Complications Study. We did a cross-sectional nested case-control study from the EURODIAB Prospective Complications Study of 543 ( 278 men) European individuals with type 1 diabetes diagnosed at < 36 years of age. We used linear regression analyses to investigate the association of pulse pressure with glycation products. Pulse pressure was significantly associated with plasma levels of N-epsilon- (carboxymethyl) lysine and N-epsilon- (carboxyethyl) lysine but not with HbA1c, Amadori albumin, and urinary levels of pentosidine. Regression coefficients adjusted for age, sex, mean arterial pressure, and duration of diabetes were 0.09 mm Hg ( P = 0.003) per 1 mu M/ M lysine N-epsilon- ( carboxymethyl) lysine; 0.24 mm Hg ( P = 0.001) and - 0.03 mm Hg ( P = 0.62) per 1 mu M/M lysine N-epsilon- (carboxyethyl) lysine ( in individuals with and without complications, respectively; P interaction = 0.002); and 0.50 mm Hg ( P = 0.16) per 1% HbA1c; 0.07 mm Hg ( P = 0.12) per 1 U/mL Amadori albumin; and 0.77 mm Hg ( P = 0.48) per 1 nmol/mmol creatinine pentosidine. In young type 1 diabetic individuals, arterial stiffness is strongly associated with the advanced glycation end products N-epsilon-( carboxymethyl) lysine and N-epsilon( carboxyethyl) lysine. These findings suggest that the formation of advanced glycation end products is an important pathway in the development of arterial stiffness in young type 1 diabetic individuals.