Methylglyoxal, glyoxalases and the development of diabetic complications.

The formation of the reactiveα,β-dicarbonyl metabolite, methylglyoxal, is increased during hyperglycaemia associated with diabetes mellitus. Methylglyoxal is metabolised to S-D-lactoylglutathione and D-lactate by the glyoxalase system and to hydroxyacetone (95%) and D-lactaldehyde by aldose reductase. Methylglyoxal and hydroxyacetone bind and modify protein, producing fluorescent products. Red blood cell activities of glyoxalase enzymes are risk factors for the development of clinical complications of diabetes. Aldose reductase inhibitors decrease the concentration of methylglyoxal in experimental diabetic rats to normal levels, aminoguanidine and L-arginine scavenge methylglyoxal; these effects may be involved in their prospective preventive therapy of diabetic complications. Biochemical and clinical evidence suggests that the metabolism of methylglyoxal in diabetes mellitus is linked to the development of diabetic complications. A causal relationship may involve modification of protein by methylglyoxal and hydroxyacetone.