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Glycation of Skin Collagen in Type I Diabetes Mellitus: Correlation With Long-Term Complications

Nonenzymatic glycosylation (glycation) of collagen was measured by boronate affinity chromatography in skin biopsies from 41 type I diabetics with mean duration of diabetes of 25 yr (range 20–40 yr) and from 25 age-matched controls. Mean level of Amadori products was significantly increased in diabetic [7.85 ± 1.78 (SD) nmol/mg collagen] versus control subjects [3.34 ± 1.06 (SD) nmol/mg collagen, P < .001] but did not correlate with age, diabetes duration, or severity of retinopathy, nephropathy, arterial stiffness, and joint stiffness. Similarly, mean collagen content per biopsies was 42% increased in diabetic versus control subjects (P < .001) but did not correlate with age, diabetes duration, or severity of complications. A weak but positive correlation between glycohemoglobin level and glycation of skin collagen was observed. These results indicate that Amadori products cannot explain by themselves the pathogenesis of diabetic complications unless individual tissue response to glycation is different in subjects with and without complication. They do not exclude a role for the late stages of the Maillard reaction, nonenzymatic browning, in the formation of some of these complications.