Individual Glycation Sites as Biomarkers of Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes mellitus (T2DM) is a widely spread metabolic disease, the initial stages of which are asymptomatic and have no clinically recognizable manifestation. At the molecular level, T2DM is manifested with essential non-enzymatic structural changes of intra- and extracellular proteins, mostly represented with oxidation and glycation of multiple residues. Protein glycation is one of the most universal markers of T2DM, and is recognized as an indirect, but adequate indicator of plasma glucose levels over prolonged periods of time. Unfortunately, glycated hemoglobin (HbA1c) – the universally accepted T2DM marker, is insensitive for short-term excursions of blood glucose, which are known to precede the onset of disease. Therefore, new generation biomarkers, giving access to the time dimension of Maillard reaction in blood, are desired. In this context, establishment of individual glycation sites of plasma proteins as new T2DM biomarkers might be a promising approach. Indeed, involvement of proteins with different half-life times in such analysis will make the time dimension of protein glycation in blood available and will allow early recognition of blood sugar fluctuations, occurring within few weeks or even days.