Nonenzymatic glycosylation of macromolecules. Prospects of pharmacologic modulation.

Diabetes increases the risk of developing atherosclerotic arterial disease significantly. Although elevated glycohemoglobin was shown to be an independent risk factor in older women in the Framingham Heart Study, the relationship between hyperglycemia and macrovascular disease is complicated by the many other factors that influence atherogenesis in nondiabetic people. Studies in vitro suggest that chronic hyperglycemia may accelerate the atherogenic process through excessive glycation of various components of the arterial wall. These data are reviewed critically, and the biochemistry and pharmacological potential of the glycation-inhibitor aminoguanidine is discussed.