Uribarri Jaime, Peppa Melpomeni, Cai Wejing, Goldberg Teresia, Lu Min, Baliga Suresh, Vassalotti Joseph A, Vlassara Helen
Department of Medicine, Division of Nephrology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Am J Kidney Dis. 2003 Sep;42(3):532-8. doi: 10.1016/s0272-6386(03)00779-0.
Levels of advanced glycation end products (AGEs), well-known proinflammatory compounds, are markedly elevated in patients with renal failure, raising the speculation that they have a role as cardiovascular risk factors in this population. Although elevated AGE levels in patients with renal failure have been attributed to impaired renal clearance and increased endogenous AGE formation, recent data suggest an important role for diet as a source of AGEs.
To determine the relationship between dietary AGE content and serum AGE levels, a cross-sectional study was performed in our long-term dialysis patients. Dietary AGE intake was estimated by means of dietary records and questionnaires, and sera were obtained for measurement of 2 well-characterized AGEs, carboxymethyl-lysine (CML) and methylglyoxal (MG) derivatives.
The study population included 189 patients; 139 hemodialysis and 50 peritoneal dialysis patients. Serum CML level correlated significantly with dietary AGE intake, based on either 3-day food records (r = 0.5; P = 0.003) or dietary questionnaires (r = 0.22; P = 0.03). Although no correlation was observed with nutrient intake (protein, fat, saturated fat, or carbohydrate), both serum CML and MG levels correlated with blood urea nitrogen (r = 0.2; P = 0.03 and r = 0.2; P = 0.02, respectively) and serum albumin levels (r = 0.16; P = 0.04 and r = 0.18; P = 0.02, respectively).
Data indicate that dietary AGE content, independently of other diet constituents, is an important contributor to excess serum AGE levels in patients with renal failure. Moreover, the lack of correlation between serum AGE levels and dietary protein, fat, and carbohydrate intake indicates that a reduction in dietary AGE content can be obtained safely without compromising the content of obligatory nutrients.
晚期糖基化终末产物（AGEs）是一类众所周知的促炎化合物，在肾衰竭患者体内水平显著升高，这引发了一种推测，即它们在该人群中作为心血管危险因素发挥作用。尽管肾衰竭患者体内AGE水平升高被认为归因于肾脏清除功能受损和内源性AGE生成增加，但最近的数据表明饮食作为AGEs的一个来源起着重要作用。
为了确定饮食中AGE含量与血清AGE水平之间的关系，我们对长期透析患者进行了一项横断面研究。通过饮食记录和问卷调查估算饮食中AGE的摄入量，并采集血清以测量两种特征明确的AGEs，即羧甲基赖氨酸（CML）和甲基乙二醛（MG）衍生物。
研究人群包括189名患者；139名血液透析患者和50名腹膜透析患者。基于3天的饮食记录（r = 0.5；P = 0.003）或饮食问卷（r = 0.22；P = 0.03），血清CML水平与饮食中AGE摄入量显著相关。尽管未观察到与营养物质摄入量（蛋白质、脂肪、饱和脂肪或碳水化合物）存在相关性，但血清CML和MG水平均与血尿素氮相关（分别为r = 0.2；P = 0.03和r = 0.2；P = 0.02）以及血清白蛋白水平相关（分别为r = 0.16；P = 0.04和r = 0.18；P = 0.02）。
数据表明，饮食中AGE含量独立于其他饮食成分，是肾衰竭患者血清AGE水平过高的一个重要因素。此外，血清AGE水平与饮食中蛋白质、脂肪和碳水化合物摄入量之间缺乏相关性表明，在不影响必需营养素含量的情况下，可以安全地降低饮食中AGE的含量。
