Scientific Research and Essays Vol. 6(9), pp. 1957-1962, 4 May, 2011
Available online at http://www.academicjournals.org/SRE
ISSN 1992-2248 ©2011 Academic Journals
Full Length Research Paper
Evaluation of N
ε
-(carboxymethyl)lysine and lipid
peroxidation in multiethnic Malaysian subjects with
type 2 diabetes mellitus
Khaled Abdul-Aziz Ahmed
1, 2
*, Sekaran Muniandy
1
, Ikram Shah Ismail
3
, Reyadh Saif Ali
1
, and
Zaid Hizam Alhamodi
1
1
Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
2
Faculty of Dentistry, Ibb University, P.O.Box 70627, Ibb, Yemen.
3
Department of Endocrinology, University of Malaya Medical Center, University of Malaya, 50603 Kuala Lumpur,
Malaysia.
Accepted 4 March, 2011
The glycoxidation product, N
ε
-(carboxymethyl)lysine (CML), is formed during reaction of glucose with
protein under oxidative conditions. The aim of the study was to evaluate the levels of the most common
glycoxidation product; N
ε
-(carboxymethyl)lysine (CML) and the most advanced lipoxidation product,
malondialdehyde (MDA) in type 2 diabetic Malay, Indian, and Chinese ethnic groups in the Malaysian
population. Studies were performed on age-matched Malay, Indian, and Chinese subjects with type 2
diabetes mellitus. Different biochemical parameters including serum levels of CML, MDA, lipid profile,
glucose, and hemoglobin A1c (HbA
1c
) were measured by standard methods. The relationships between
circulating CML and lipids, HbA
1c
, and MDA, were examined. Correlation studies between CML, lipids,
HbA
1c
, and lipid peroxidation were performed. CML and MDA levels were significantly higher in Malay
subjects than in Indian or Chinese patients (p <0.005). A significant difference was also observed in the
levels of serum total cholesterol and LDL-cholesterol (p <0.05) between the groups in the study. A
positive correlation was observed between serum levels of CML and MDA in Malay diabetic patients, but
no such correlation was seen in either the Chinese or Indian populations. The results of this study
demonstrate that ethnicity affects CML and MDA circulating levels in Malaysian subjects with type 2
diabetes mellitus.
Key words: Type 2 diabetes mellitus, N
ε
-(carboxymethyl) lysine, lipoxidation, multiethnic Malaysian subjects.
INTRODUCTION
Type 2 diabetes is the most common form of diabetes
comprising 80 to 90% of all diabetic people. Type 2
diabetes mellitus (T2DM) is a global health problem
affecting approximately 4.0% of adults in the world in
1995 (Harris et al., 1998) and this prevalence has been
projected to increase to 5.4% by 2025 (King et al., 1998).
Epidemiological data have considered hyperglycemia to
be a major player in the development of macrovascular
complications such as coronary artery disease (CAD) and
stroke (Laakso, 1999). Macrovascular complications of
*Corresponding author. E-mail: khaaah@gmail.com.
diabetes mellitus (DM) are due to accelerated athero-
sclerosis and have an important role in the increased
morbidity and mortality suffered by these individuals
(Wingard and Barrett-Connor, 1995). For example, a
recent meta-analysis study showed that the rate of fatal
CAD is higher in diabetic patients than in non-diabetic
individuals (5.4% vs. 1.6%) (Huxley et al., 2006).
Diabetes causes oxidative stress, not only due to the
increased production of mitochondrial reactive oxygen
species (ROS) or an impaired endogenous capacity to
scavenge free radicals (Brownlee, 2001), but also due to
glucose auto-oxidation (Wolff et al., 1991), and to the
non-enzymatic glycation of proteins (Brownlee, 2000). In
vivo glycation and lipid peroxidation reactions may play a