Increased circulating advanced glycation endproducts (AGEs) in acute trauma patients

Carl I Schulman, Jaime Uribarri, Weijing Cai, Ron Manning, David C. Landy, Margaret Gallardo, Angela Castillo, Nicholas Namias, Gary E. Striker, Alan Livingstone, Helen Vlassara

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Circulating levels of pro-inflammatory advanced glycation end products (AGEs) are increased in diabetes and other conditions characterized by chronically elevated oxidant stress (OS). OS also increases after acute trauma and is implicated in the development of complications such as multiple organ failure. Herein, we assess the effect of acute OS on circulating levels of AGEs in a cohort of acute trauma victims. Methods: An observational study was performed at a large Level 1 Trauma Center. Blood samples for measurement of two AGEs, carboxymethyllysine (CML) and methylglyoxal (MG), were obtained at admission, and serially afterwards in patients admitted to the ICU. Demographics, dietary history, markers of injury severity and ICU morbidity and mortality data were collected. Results: One hundred and fifty-six trauma patients (TP) (age: 39 ± 17 years, 83% males, injury severity score: 18 ± 14) were included in the study. TP had significantly higher serum AGE levels than normal healthy controls (CML, TP 12.4 ± 8.2 U/mL vs. controls 8.9 ± 5.3 U/mL, p < 0.001; MG, TP 2.1 ± 1.4 nmol/mL vs. controls 0.79 ± 0.3 nmol/mL, p < 0.001). Admission serum AGE levels in 49 severe TP admitted to the ICU were lower than those who were not. However, among the ICU patients, serum AGEs increased further for about 7 days in patients with an uncomplicated course, and remained markedly elevated in those with a complicated course. Conclusions: Circulating AGEs are transiently increased after acute trauma and persistently elevated AGE levels are associated with greater severity of injury.

Original languageEnglish
Pages (from-to)103-108
Number of pages6
JournalClinical Chemistry and Laboratory Medicine
Volume52
Issue number1
DOIs
StatePublished - Jan 1 2014

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Intensive care units
Oxidants
Pyruvaldehyde
Wounds and Injuries
Advanced Glycosylation End Products
Medical problems
Blood
Serum
Injury Severity Score
Multiple Organ Failure
Trauma Centers
Observational Studies
Demography
N(6)-carboxymethyllysine
Morbidity

Keywords

  • dietary AGEs
  • glycation
  • nutrition
  • oxidative stress

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Increased circulating advanced glycation endproducts (AGEs) in acute trauma patients. / Schulman, Carl I; Uribarri, Jaime; Cai, Weijing; Manning, Ron; Landy, David C.; Gallardo, Margaret; Castillo, Angela; Namias, Nicholas; Striker, Gary E.; Livingstone, Alan; Vlassara, Helen.

In: Clinical Chemistry and Laboratory Medicine, Vol. 52, No. 1, 01.01.2014, p. 103-108.

Research output: Contribution to journalArticle

Schulman, CI, Uribarri, J, Cai, W, Manning, R, Landy, DC, Gallardo, M, Castillo, A, Namias, N, Striker, GE, Livingstone, A & Vlassara, H 2014, 'Increased circulating advanced glycation endproducts (AGEs) in acute trauma patients', Clinical Chemistry and Laboratory Medicine, vol. 52, no. 1, pp. 103-108. https://doi.org/10.1515/cclm-2012-0834
Schulman, Carl I ; Uribarri, Jaime ; Cai, Weijing ; Manning, Ron ; Landy, David C. ; Gallardo, Margaret ; Castillo, Angela ; Namias, Nicholas ; Striker, Gary E. ; Livingstone, Alan ; Vlassara, Helen. / Increased circulating advanced glycation endproducts (AGEs) in acute trauma patients. In: Clinical Chemistry and Laboratory Medicine. 2014 ; Vol. 52, No. 1. pp. 103-108.
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AU - Schulman, Carl I

AU - Uribarri, Jaime

AU - Cai, Weijing

AU - Manning, Ron

AU - Landy, David C.

AU - Gallardo, Margaret

AU - Castillo, Angela

AU - Namias, Nicholas

AU - Striker, Gary E.

AU - Livingstone, Alan

AU - Vlassara, Helen

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N2 - Background: Circulating levels of pro-inflammatory advanced glycation end products (AGEs) are increased in diabetes and other conditions characterized by chronically elevated oxidant stress (OS). OS also increases after acute trauma and is implicated in the development of complications such as multiple organ failure. Herein, we assess the effect of acute OS on circulating levels of AGEs in a cohort of acute trauma victims. Methods: An observational study was performed at a large Level 1 Trauma Center. Blood samples for measurement of two AGEs, carboxymethyllysine (CML) and methylglyoxal (MG), were obtained at admission, and serially afterwards in patients admitted to the ICU. Demographics, dietary history, markers of injury severity and ICU morbidity and mortality data were collected. Results: One hundred and fifty-six trauma patients (TP) (age: 39 ± 17 years, 83% males, injury severity score: 18 ± 14) were included in the study. TP had significantly higher serum AGE levels than normal healthy controls (CML, TP 12.4 ± 8.2 U/mL vs. controls 8.9 ± 5.3 U/mL, p < 0.001; MG, TP 2.1 ± 1.4 nmol/mL vs. controls 0.79 ± 0.3 nmol/mL, p < 0.001). Admission serum AGE levels in 49 severe TP admitted to the ICU were lower than those who were not. However, among the ICU patients, serum AGEs increased further for about 7 days in patients with an uncomplicated course, and remained markedly elevated in those with a complicated course. Conclusions: Circulating AGEs are transiently increased after acute trauma and persistently elevated AGE levels are associated with greater severity of injury.

AB - Background: Circulating levels of pro-inflammatory advanced glycation end products (AGEs) are increased in diabetes and other conditions characterized by chronically elevated oxidant stress (OS). OS also increases after acute trauma and is implicated in the development of complications such as multiple organ failure. Herein, we assess the effect of acute OS on circulating levels of AGEs in a cohort of acute trauma victims. Methods: An observational study was performed at a large Level 1 Trauma Center. Blood samples for measurement of two AGEs, carboxymethyllysine (CML) and methylglyoxal (MG), were obtained at admission, and serially afterwards in patients admitted to the ICU. Demographics, dietary history, markers of injury severity and ICU morbidity and mortality data were collected. Results: One hundred and fifty-six trauma patients (TP) (age: 39 ± 17 years, 83% males, injury severity score: 18 ± 14) were included in the study. TP had significantly higher serum AGE levels than normal healthy controls (CML, TP 12.4 ± 8.2 U/mL vs. controls 8.9 ± 5.3 U/mL, p < 0.001; MG, TP 2.1 ± 1.4 nmol/mL vs. controls 0.79 ± 0.3 nmol/mL, p < 0.001). Admission serum AGE levels in 49 severe TP admitted to the ICU were lower than those who were not. However, among the ICU patients, serum AGEs increased further for about 7 days in patients with an uncomplicated course, and remained markedly elevated in those with a complicated course. Conclusions: Circulating AGEs are transiently increased after acute trauma and persistently elevated AGE levels are associated with greater severity of injury.

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KW - glycation

KW - nutrition

KW - oxidative stress

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