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574 This contrasts with ab initio predictions that addition reactions through the nitrogen should be favored in polar media, although the difference in the free energy barriers for hydrogen abstraction and free radical addition is small

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Limitations were the small number of studies included in the statistical analysis, the inclusion of observational studies, the potential bias from selecting only English-language studies, the lack of very long-term follow-up data, the limited geographical origin of population and finally the lack of stratification by fibrosis

4-HNE is generally considered to be a marker of oxidative stress (Leake et al., 2012), so the level of 4-HNE and its adducts can indicate the severity of diabetic complications