In people with diabetes, glycation of apolipoproteins correlates with other indices of recent glycemic control, including HbA1. For several reasons, increased glycation of apolipoproteins may play a role in the accelerated development of atherosclerosis in diabetic patients. Recognition of glycated LDL by the classical LDL receptor is impaired, whereas its uptake by human monocyte-macrophages is enhanced. These alterations may contribute to hyperlipidemia and accelerated foam-cell formation, respectively. Glycation of LDL also enhances its capacity to stimulate platelet aggregation. The uptake of VLDL from diabetic patients by human monocytemacrophages is enhanced. This enhancement may be due, at least in part, to increased glycation of its lipoproteins. Glycation of HDL impairs its recognition by cells and reduces its effectiveness in reverse cholesterol transport. Glycation of apolipoproteins may also generate free radicals, increasing oxidative damage to the apolipoproteins themselves, the lipids in the particle core, and any neighboring macromolecules. This effect may be most significant in extravasated lipoproteins. In these, increased glycation promotes covalent binding to vascular structural proteins, and oxidative reactions may cause direct damage to the vessel wall. Glycoxidation, or browning, of sequestered lipoproteins may further enhance their atherogenicity. Finally, glycated or glycoxidized lipoproteins may be immunogenic, and lipoprotein-immune complexes are potent stimulators of foam-cell formation.
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October 01 1992
Lipoprotein Glycation and Its Metabolic Consequences
Timothy J Lyons
Timothy J Lyons
Division of Endocrinology, Diabetes, and Metabolism, Medical University of South Carolina, and Ralph H. Johnson Department of Veterans Affairs Medical Center
Charleston, South Carolina
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Address correspondence and reprint requests to Timothy J. Lyons, MD, MRCP, Division of Endocrinology, Metabolism and Nutrition, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425
Diabetes 1992;41(Supplement_2):67–73
Article history
Received:
April 03 1992
Accepted:
May 12 1992
PubMed:
1526339
Citation
Timothy J Lyons; Lipoprotein Glycation and Its Metabolic Consequences. Diabetes 1 October 1992; 41 (Supplement_2): 67–73. https://doi.org/10.2337/diab.41.2.S67
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