N⑀ -(Carboxymethyl)lysine (CML) is a stable chemical modification of proteins formed from both carbohydrates and lipids during autoxidation reactions. We hypothesized that carboxymethyl lipids such as (carboxymethyl)phosphatidylethanolamine (carboxymethyl-PE) would also be formed in these reactions, and we therefore developed a gas chromatography-mass spectrometry assay for quantification of carboxymethylethanolamine (CME) following hydrolysis of phospholipids. In vitro, CME was formed during glycation of dioleoyl-PE under air and from linoleoylpalmitoyl-PE, but not from dioleoyl-PE, in the absence of glucose. In vivo, CME was detected in lipid extracts of red blood cell membranes, ϳ0.14 mmol of CME/mol of ethanolamine, from control and diabetic subjects, (n ؍ 22, p > 0.5). Levels of CML in erythrocyte membrane proteins were ϳ0.2 mmol/mol of lysine for both control and diabetic subjects (p > 0.5). For this group of diabetic subjects there was no indication of increased oxidative modification of either lipid or protein components of red cell membranes. CME was also detected in fasting urine at 2-3 nmol/mg of creatinine in control and diabetic subjects (p ؍ 0.085). CME inhibited detection of advanced glycation end product (AGE)-modified protein in a competitive enzyme-linked immunosorbent assay using an anti-AGE antibody previously shown to recognize CML, suggesting that carboxymethyl-PE may be a component of AGE lipids detected in AGE low density lipoprotein. Measurement of levels of CME in blood, tissues, and urine should be useful for assessing oxidative damage to membrane lipids during aging and in disease.The nonenzymatic reaction of blood glucose with body proteins (glycation) followed by browning and oxidation reactions of glycated proteins leads to cumulative chemical modifications of tissue proteins throughout the body. These chemical changes, collectively termed the Maillard reaction, are considered to cause a gradual deterioration in the structure and function of tissue proteins and to contribute to the pathophysiology of normal aging (1-3). Further, the Maillard reaction is accelerated during hyperglycemia in diabetes, yielding advanced glycation end products (AGEs) 1 thought to be involved in the pathogenesis of diabetic complications (4 -6). Among Maillard reaction products identified thus far in tissue proteins, concentrations of pentosidine (3, 7) and N ⑀ -(carboxymethyl)lysine (CML) (7) are known to increase in human skin collagen with age, and age-adjusted concentrations of both are increased in skin collagen in diabetes (7). Moreover, there is a strong relationship between levels of these products in collagen and the status of diabetic complications (8 -10). Both CML and pentosidine require oxidative conditions for their formation, hence their description as glycoxidation products (11). Recently we showed that CML can also be formed during the reaction of autoxidizing polyunsaturated fatty acids (PUFA) with proteins (12), so that its precise biochemical origin is uncertain. The formation of ...