Non enzymatic glycated proteins in the blood and cardiovascular disease.

The study of the role of glycemia in the causation of cardiovascular disease has been limited by several factors, above all by its measurement over time. Non enzymatic glycated proteins in the blood, the product of the non enzymatic reaction of a reducing sugar with the reactive amino acid of a target protein, are an integrated measure of blood glucose over days to weeks. They have been used in the management of clinical diabetes mellitus, but are still infrequently used in epidemiological studies in non diabetic subjects. There are few epidemiological studies that show that glycated hemoglobin, fructosamine, an index of total non enzymatic glycated proteins in the blood, and glycated apolipoprotein B and other non enzymatic glycated proteins in the blood in non diabetic subjects are associated with cardiovascular diseases. In this paper we review: 1) the overall mechanisms of non enzymatic glycation of proteins; 2) the measurement of glycated hemoglobin, fructosamine, and glycated apolipoprotein B and their relationship with blood glucose levels in non diabetic subjects; 3) the association of glycated hemoglobin, fructosamine and glycated apolipoprotein B with cardiovascular disease. We conclude that non enzymatic glycation of protein in the blood is associated with cardiovascular disease also in non diabetic subjects, and could be used to define dietary risk factors of cardiovascular disease.