Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
Am J Clin Nutr. 2020 Jul 1;112(1):129-137. doi: 10.1093/ajcn/nqaa117.
Advanced glycation end products (AGEs) accumulate in tissues with age and in conditions such as diabetes mellitus and chronic kidney disease (CKD), and they may be involved in age-related diseases. Skin AGEs measured as skin autofluorescence (SAF) are a noninvasive reflection of long-term AGE accumulation in tissues. Whether AGEs present in the diet (dAGEs) contribute to tissue AGEs is unclear.
Our aim was to investigate the association between dietary and skin AGEs in the Rotterdam Study, a population-based cohort of mainly European ancestry.
In 2515 participants, intake of 3 dAGEs [carboxymethyl-lysine (CML), N-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MGH1), and carboxyethyl-lysine (CEL)] was estimated using FFQs and the content of AGEs measured in commonly consumed foods. SAF was measured 5 y (median value) later using an AGE Reader. The association of dAGEs with SAF was analyzed in linear regression models and stratified for diabetes and chronic kidney disease (CKD, defined as estimated glomerular filtration rate ≤60 mL/min) status.
Mean ± SD intake was 3.40 ±0.89 mg/d for CML, 28.98 ±7.87 mg/d for MGH1, and 3.11 ±0.89 mg/d for CEL. None of them was associated with SAF in the total study population. However, in stratified analyses, CML was positively associated with SAF after excluding both individuals with diabetes and individuals with CKD: 1 SD higher daily CML intake was associated with a 0.03 (95% CI: 0.009, 0.05) arbitrary units higher SAF. MGH1 and CEL intake were not significantly associated with SAF. Nevertheless, the associations were stronger when the time difference between dAGEs and SAF measurements was shorter.
Higher dietary CML intake was associated with higher SAF only among participants with neither diabetes nor CKD, which may be explained by high AGE formation in diabetes and decreased excretion in CKD or by dietary modifications in these disease groups. The dAGE-SAF associations were also modified by the time difference between measurements. Our results suggest that dAGEs can influence tissue AGE accumulation and possibly thereby age-related diseases. This trial was registered at the Netherlands National Trial Register as NTR6831 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6831) and at the WHO International Clinical Trials Registry Platform as NTR6831 (http://www.who.int/ictrp/network/primary/en/).
晚期糖基化终产物（AGEs）在组织中随着年龄的增长以及在糖尿病和慢性肾脏病（CKD）等情况下积累，它们可能与年龄相关的疾病有关。皮肤 AGEs 可以通过皮肤自发荧光（SAF）来测量，这是组织中长期 AGE 积累的非侵入性反映。饮食中的 AGEs（dAGEs）是否会导致组织中的 AGEs 尚不清楚。
我们旨在研究鹿特丹研究中饮食和皮肤 AGEs 之间的关联，鹿特丹研究是一个主要以欧洲血统为基础的人群队列。
在 2515 名参与者中，使用 FFQ 估计了 3 种 dAGEs[羧甲基赖氨酸（CML）、N-（5-羟基-5-甲基-4-咪唑啉-2-基）-鸟氨酸（MGH1）和羧乙基赖氨酸（CEL）]的摄入量，并测量了常用食物中的 AGEs 含量。5 年后（中位数）使用 AGE 阅读器测量 SAF。使用线性回归模型分析 dAGEs 与 SAF 的相关性，并按糖尿病和慢性肾脏病（定义为估计肾小球滤过率≤60ml/min）状态进行分层。
CML、MGH1 和 CEL 的平均每日摄入量分别为 3.40±0.89mg/d、28.98±7.87mg/d 和 3.11±0.89mg/d。在整个研究人群中，它们与 SAF 均无相关性。然而，在分层分析中，在排除糖尿病和 CKD 患者后，CML 与 SAF 呈正相关：每日 CML 摄入量增加 1 个标准差与 SAF 增加 0.03（95%CI：0.009，0.05）个任意单位有关。MGH1 和 CEL 的摄入量与 SAF 无显著相关性。然而，当 dAGEs 和 SAF 测量之间的时间差较短时，相关性更强。
在既没有糖尿病也没有 CKD 的参与者中，较高的饮食 CML 摄入量与较高的 SAF 有关，这可能是由于糖尿病中 AGE 形成增加和 CKD 中排泄减少，或由于这些疾病组的饮食改变所致。dAGE-SAF 之间的关联也受到测量之间时间差的影响。我们的结果表明，dAGEs 可以影响组织 AGE 积累，并可能影响与年龄相关的疾病。该试验在荷兰国家试验注册处注册为 NTR6831（http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6831），并在世界卫生组织国际临床试验注册平台注册为 NTR6831（http://www.who.int/ictrp/network/primary/en/）。
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