Association of advanced glycation end products (AGEs) with endothelial dysfunction, oxidative stress in gestational diabetes mellitus (GDM)

Background Advanced glycation end products (AGEs) are major risk factors for vascular complications in diabetes. Its role in gestational diabetes mellitus (GDM) and vascular complications in GDM is not known. Objective The present study was aimed to study the association of AGEs with GDM and vascular inflammation. Methods Plasma samples from normal pregnant and GDM women (n = 50 each) were obtained from two tertiary referral centers in Tamil Nadu, India. Quantification of AGEs, methylglyoxal (MGO), ICAM-1, and malondialdehyde (MDA) were performed by commercially available ELISA kits. Results and conclusions The third trimester fasting blood sugar (101.35 +/- 26.15 vs. 81.63 +/- 6.14, p < 0.002) and postprandial blood sugar (150.69 +/- 23.07 vs 105.79 +/- 11.99, p < 0.0001) were significantly high in GDM women compared to normal pregnant women. The concentrations of AGEs (13.18 +/- 8.74, p < 0.001), MGO (15.7 +/- 13.54, p < 0.02), and ICAM-1 (217.8 +/- 86.92, p = 0.005) were significantly higher in GDM women compared to AGEs (2.68 +/- 0.89), MGO (9.26 +/- 5.38), and ICAM-1 (142.3 +/- 38.21) in normal pregnant women. Further, elevated levels of MDA concentration (0.64 +/- 0.08, p < 0.002) and low GSH levels (0.19 +/- 0.1, p < 0.0001) in the GDM women were indicative of oxidative stress. AGE levels significantly correlated with MDA concentration which indicates AGEs may be responsible for oxidative stress in GDM women. Further, elevated level of ICAM-1 in GDM women suggests endothelial activation which may impact endothelial function. Thus, AGEs may be used as a biomarker during pregnancy to predict vascular complications due to GDM.