Maruf MH, et al. - In this investigation, researchers analyzed and compared ligamentum flavum (LF) histology concentrated on advanced glycation end product (AGE) status between control patients, lumbar spinal stenosis (LSS) patients with diabetes mellitus (DM), and LSS patients without DM. For this analysis, 10 LF specimens from LSS patients with DM, 10 from LSS patients without DM, and 9 from patients with lumbar disc herniation or cauda equina tumor were harvested during surgery and histologically analyzed. In the LF of DM patients, the accumulation of AGEs is significantly higher and correlates with patient age. AGEs can accelerate age-related degeneration and hypertrophy of LF and may result in a greater incidence of LSS in DM patients. The current findings partially show the molecular mechanism of LF hypertrophy, indicating that in the elderly and patients with DM, AGEs may be involved in the process of LF degeneration.