Assessment of advanced glycation end-products as a biomarker of diabetic outcomes
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Published on: May 2, 2025
Olga Simó-Servat1, Alejandra Planas2, Andreea Ciudin1
1Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain.
Insights
Advanced glycation end-products (AGEs) show promise as biomarkers for diabetic complications, offering insights beyond HbA1c. Non-invasive measurements of AGEs could improve risk identification for long-term diabetes management.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Biomarker Discovery
Background:
- Hemoglobin A1c (HbA1c) is standard for metabolic control but inadequately predicts diabetic complications.
- HbA1c lacks information on glycemic variability and long-term hyperglycemia.
- Diabetic complications are linked to the accumulation of advanced glycation end-products (AGEs).
Purpose of the Study:
- To summarize evidence supporting advanced glycation end-products (AGEs) as biomarkers for diabetic complications.
- To evaluate the potential of non-invasive AGE measurements in clinical practice.
Main Methods:
- Review of existing evidence on AGE accumulation and diabetic complications.
- Analysis of fluorescence properties for non-invasive AGE measurement in tissues like skin and lens.
Main Results:
- Advanced glycation end-products (AGEs) are implicated in the pathogenesis of diabetic complications.
- Non-invasive measurement of AGEs in tissues is feasible due to their fluorescence.
- AGE accumulation may serve as a promising biomarker for late diabetic complications.
Conclusions:
- Non-invasive AGE measurements show potential as biomarkers for diabetic complications.
- Further translational research and clinical trials are necessary.
- Current evidence suggests AGEs could complement HbA1c in assessing diabetic complication risk.
Abstract:
There are substantial differences in the onset and severity of diabetes complications that are not fully explained by HbA1c levels and other risk factors. HbA1c is the gold standard for assessing metabolic control, but has limited value to identify patients at risk of developing diabetic complications. The main disadvantage of HbA1c is that it does not provide information about glycemic variability and does not reflect long-term exposure to hyperglycemia. One of the main pathogenetic mechanisms of diabetic complications is the generation and accumulation of advanced glycation end-products (AGEs). Based on its fluorescence properties, AGEs may be measured in tissues such as the skin or lens. These non-invasive measurements of AGE accumulation may be considered as promising biomarkers of late diabetic complications, and our objective is to summarize the available evidence supporting this statement. However, further translational research and prospective clinical trials are needed before these new biomarkers may be incorporated into clinical practice.
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