Ascorbic acid, glycation, glycohemoglobin and aging

Abstract

The glycation of proteins alters both their structure and function. These changes have been linked to diabetic disorders and aging. The glycation of hemoglobin is also used as a diagnostic tool; the extent of glycation being a reflection of blood glucose averaged over a two to three month period. Accurate measures of average blood sugar (e.g., glycohemoglobin (GHb)) are important in clinical management of diabetes, pregnancy, cancer, etc. Ascorbic acid (AA) can react with proteins, including hemoglobin, and possibly interfere with GHb measurements. Past reports on the impact of AA on in vivo glycation have been equivocal. We studied GHb in subjects supplementing up to 20 g AA daily and found that for each 30 micromol/L increase in plasma AA, GHb was reduced by approximately 0.1. These results suggest that high AA intake can depress glycation, reduce GHb and lead to a clinically relevant underestimation of average blood sugar. Because AA is the most commonly consumed dietary supplement, awareness of an AA-associated bias in GHb is imperative. Of even broader significance is the possibility of AA-mediated inhibition of glycation in all proteins and the implications for aging. Moreover, AA could contribute through several other mechanisms to slowing of human aging (e.g., antioxidant properties, acceleration of pentose phosphate pathway, replacement of structural proteins).