Changes in the albumin glycation site, plasma pentosidine and esRAGE concentrations before and after intensive diabetic treatment in patients with abnormally high glycated albumin levels.

Background We have reported that the blood glucose normalization treatment reduced the albumin glycation sites and the intensity of albumin AGE fluorescence in patients with abnormally high glycated albumin levels. To clarify the relationship between glycaemic control status and levels of glycated proteins and related markers, we studied the change of the markers of the DM patients with and without fatty liver, liver cirrhosis and dialysis before and after the intensive diabetic treatment. Methods Eight diabetic patients with abnormally high glycated albumin levels (no complications: 2, fatty liver: 3, liver cirrhosis: 2, dialysis: 1) were recruited. In the hypoglycaemic treatment for these patients, the HbA1c, glycated albumin, albumin AGE fluorescence, pentosidine, endogenous secretory receptors for AGE (esRAGE) and glycation sites of albumin were determined. Results Glycated albumin and HbA1c levels dropped after the treatment. Albumin glycation sites decreased in almost the same pattern, irrespective of the type of complications. The fluorescence intensity and pentosidine concentrations decreased significantly. However, post-treatment pentosidine concentrations were higher than the reference interval in all cases. Average esRAGE concentrations did not change and were lower than the reference interval. Conclusions Hypoglycaemic treatment reduced the glycated albumin levels, glycation sites of albumin and AGE concentrations but not esRAGE concentrations in diabetic patients with or without fatty liver, liver cirrhosis, and dialysis. Checking and maintaining low glycated albumin levels would prevent the formation of AGE and may be useful to prevent the onset or progression of diabetes complications.