1. Introduction
Diabetes, vascular complications, diabetes
VASCULAR COMPLICATIONS, METABOLIC DISORDER, DISORDERS, DIABETES, OXIDATIVE STRESS, PATHOGENESIS, DIABETES
Reactive α-dicarbonyls (α-DCs), such as methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG), are potent precursors in the formation of advanced glycation end products (AGEs). In particular, MGO and MGO-derived AGEs are thought to be involved in the development of vascular complications in diabetes. Experimental studies showed that citrus and pomegranate polyphenols can scavenge α-DCs. Therefore, the aim of this study was to evaluate the effect of a citrus and pomegranate complex (CPC) on the α-DCs plasma levels in a double-blind, placebo-controlled cross-over trial, where thirty-six elderly subjects were enrolled. They received either 500 mg of Despite substantial advances in diabetes treatment, vascular complications remain a significant clinical concern and are the primary cause of mortality among diabetes patients [A natural consequence of the modification of biomacromolecules by MGO is the loss of their original spatial structure. This results in a loss of physiological function, leading to various cellular disorders [Excessive MGO formation can further increase the production of reactive oxygen species and nitrogen species and consequently induce oxidative stress, which further contributes to the development and progression of vascular complications in diabetes [Preventing diabetes vascular complications necessitates a multidirectional therapeutic approach, as simply targeting risk factors, like glycemic control and a healthy lifestyle, may not be sufficient. Diabetes is a complex metabolic disorder, and the pathogenesis of its vascular complications involves multiple interlinked biochemical, molecular, and physiological processes and, therefore, requires multidirectional therapy. Lowering systemic levels of MGO, GO, and 3-DG may delay the formation of AGEs, particularly crucial in patients experiencing pathophysiological increases in α-DCs (dicarbonyl stress) due to diabetes.To date, several agents have been studied and proposed to be useful as an anti-MGO therapy. Among them are experimental compounds, such as aminoguanidine [Plant-derived dietary supplements and nutraceuticals are becoming increasingly popular all over the world as a result of growing customer awareness regarding their potential health benefits [Several experimental in vitro studies have proved that citrus and pomegranate polyphenols can scavenge reactive α-dicarbonyls and prevent the formation of AGEs [Despite experimental evidence, controlled human studies on the effects of orange and pomegranate actives on α-DCs levels are lacking. Therefore, this post hoc analysis of a double-blind, randomized, cross-over clinical trial in apparently healthy elderly participants examines the impact of a combination of citrus extract and pomegranate concentrate (CPC) on α-DCs levels. The results may shed light on potential therapeutic approaches to inhibit hyperglycemia-induced vascular endothelial damage.