Glucosilación no enzimática y complicaciones crónicas de la diabetes mellitus

introduction: hyperglycemia is nowadays considered as a fundamental pathogenic factor for development of diabetic neurovascular complications and, specifically, plays a prevailing role in phenomenon of non-enzymatic glycosylation and the formation of end-products of advanced glycosylation. objectives: to describe the mechanisms of end-products of advanced glycosylation and its relation to complications of diabetes mellitus. development: the above mentioned end-products are produced by the non-enzymatic reaction of glucose and other derivatives including glioxal, methylglioxal and 3-desoxiblucosone with amines groups of long-life proteins. the glycosylation changes the structure, the physical-chemical properties and the function of intracellular and extracellular proteins. in basal membrane of small vessels it is produced a thickening and a structure distortion provoking the elasticity of the vascular wall and its abnormal permeability to proteins (endothelial dysfunction), as well as an increase of genesis of oxygen-reactive species. the link of end-products of advanced glycosylation with its membrane receptors favor the production of cytokines and growth factors by macrophages and mesangial cells. all above mentioned favor the development of atherosclerosis. conclusions: the end-products of advanced glycosylation play a significant role in the development of microvascular and macrovascular complications in the diabetic patient. the strict metabolic control of glycemia and at present time, the pharmacologic therapeutics including agents inhibiting the formation of end-products of the advanced glycosylation have antioxidant action or are therapeutical alternatives for prevention and solution of the problem related to chronic complications of diabetes mellitus.