Revised Manuscript Received September 28, 1995® abstract: Glycoxidation products (GOPs), such as/V6-(carboxymethyl) lysine (CML) and pentosidine, are formed during reaction of glucose with protein under oxidative conditions in vitro. It is uncertain whether these GOPs are derived from oxidation of Amadori adducts on protein or from oxidation of glucose or intermediates formedprior to the Amadori rearrangement. To address this question, we reacted collagen with 250 mM glucose in 200 mM phosphate buffer, pH 7.4, under antioxidative conditions, yielding a protein rich in Amadori adducts, but with only traces of GOPs. This “preglycated” collagen was then exposed to [l3Ce] glucose under oxidative conditions, producing both naturaland [13C2]-CML. At 200 mM phosphate buffer,[13C2]-CML was the major product, even at low (5 mM) pCejglucose concentration, indicating a limited role for Amadori compounds in formation of CML in high phosphate. The relative yields of natural and [13C2]-CML variedwith phosphate concentration, becoming similar at more physiological (10 mM) phosphate. We conclude that duringglycation of proteins at high phosphate concentrations in vitro, GOPs are formed primarily by oxidation of free glucose or rapidly-formed intermediates preceding the Amadori rearrangement, such as carbinolamine or Schiff base adducts. In contrast, at lower phosphate and glucose concentrations in vivo, the Amadori adduct may be the more significant precursor of GOPs. The fact that glycoxidation reactions proceed by multiple routes must be considered in the development of therapeutic approaches for inhibiting the Maillard reaction in diabetes.