- 期刊
最終糖化蛋白（AGEs）於臨床糖尿病併發症的應用
Clinical Implication of Advanced Glycosylation End Products in Diabetic Complications
摘要
慢性高血糖會使蛋白質糖化產生糖化產物（Amadori reactionproducts），如:糖化白蛋白（glycated albumin, GA），以及果糖氨（fructosamine）等物質，糖尿病在臨床中主要以測量糖化血色素（HbAlc）來監測長期血糖控制指標，但是HbA1c不只會受到血糖高低的影響，也會受到紅血球細胞壽命的影響，例如有血紅素疾病或是貧血的病人，HbAlc 的值會較低，導致錯誤的血糖判斷。然而最終糖化蛋白（Advanced Glycosylation End Products, AGEs），就是引起糖尿病併發症的物質，最終糖化蛋白（AGEs或AGE）又稱最終糖化產物，或稱糖化終產物或晚期糖化終產物。糖尿病患者，當身體處在高濃度葡萄糖狀態下，血液中葡萄糖上的醛基會與蛋白質上氮末端（N-terminal）的游離氨基作用，其最終產物稱為Aldimine。Aldimine相當不穩定，一旦形成Ketoamine 即呈穩定而不會再分解。因此血中葡萄糖濃度越高，所形成的糖化蛋白質濃度也越高。當血中最終糖化蛋白（AGEs）濃度上升至超出正常值，最終糖化蛋白（AGEs）會結合、活化細胞上的最終糖化蛋白受體（AGEs Receptor），同時產生超氧自由基（superoxide radicals），而被活化的最終糖化蛋白會直接誘發身體產生發炎反應，進而引發心血管病變、腎臟病變、眼睛病變、末梢神經病變等併發症產生，目前被認為是引發糖尿病併發症的主要因素之，因此要減少糖尿病的併發症，必須從監控與降低糖化蛋白的產生。
並列摘要
Hyperglycemia induces proteins glycation and yields Amadori reaction products such as glycated albumin and fructosamine. Clinically, glycated hemoglobin (HbA1c) levels are used to monitor long term glucose control. However, HbA1c is affected by the lifespan of red blood cells in addition to glucose level changes. For this reason, HbA1c levels might lead to miss judging of glucose levels in patients with hemoglobin related diseases or anemia. Advanced Glycosylation End Products (AGEs), are compounds that cause diabetic complications. When the human body is in a high glucose condition, the aldehyde group of blood glucose reacts with free amino group of the N-terminal of proteins, and forms unstable aldimines which finally become stable ketoamines that stop further decompositions. Thus, the AGEs level is proportionally related to the blood glucose level. When AGEs increase and exceed normal range, they bind and activate the AGEs receptors and yield superoxide radicals; the activated AGEs induce inflammation reactions of human body and cause further vasculopathy, nephropathy, ophthalmopathy, peripheral neuropathy, etc, AGEs have been considered as one of the factors that causes diabetic complications. Thus, AGEs should be monitored and reduced to decrease the risk of diabetic complications.