Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece.
Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 11526 Athens, Greece.
Int J Mol Sci. 2024 Oct 23;25(21):11407. doi: 10.3390/ijms252111407.
Advanced Glycation End Products (AGEs) are formed through non-enzymatic reactions between reducing sugars and proteins, nucleic acids or lipids (for example through hyperoxidation). In diabetes, elevated glucose levels provide more substrate for AGEs formation. AGEs can also be ingested through the diet from foods cooked at high temperatures, or containing much sugar. The present work aimed to review all published randomized controlled trials (RCT) on low-dietary AGE (L-dAGEs) interventions in patients with diabetes. Pubmed, Scopus and Cochrane databases were searched (until 29 February 2024) with appropriate keywords (inclusion criteria: RCT, patients with diabetes, age > 18 years, outcomes related to inflammation, glucose, and lipids; exclusion criteria: non-RCTs, case-series, case reports and Letter to the Editor, or animal studies). The present review was registered to the Open Science Framework (OSF). From 7091 studies, seven were ultimately included. Bias was assessed with the updated Cochrane Risk of Bias tool. A reduction in circulating AGEs was documented in 3/3 studies. No particular differences were documented in glycemic parameters after a L-dAGEs diet. Reductions in glucose levels were observed in one out of six studies (1/6), while HbA1c and HOMA did not change in any study (0/6 and 0/3, correspondingly). Lipid profile also changed in one out of four studies (1/4). More consistent results were observed for oxidative stress (beneficial effects in 3/3 studies) and inflammatory markers (beneficial effects in 4/4 studies). Other athero-protective effects, such as adiponectin increases, were reported. Limitations included the small sample size and the fact that dietary and physical activity habits were not considered in most studies. In conclusion, a L-dAGEs pattern may minimize AGEs accumulation and have beneficial effects on oxidative stress and inflammation indices, while its effects on glycemic and lipemic parameters are inconsistent and modest in patients with diabetes.
晚期糖基化终产物（AGEs）是通过还原糖与蛋白质、核酸或脂质之间的非酶反应形成的（例如通过过度氧化）。在糖尿病中，升高的血糖水平为 AGEs 的形成提供了更多的底物。AGEs 也可以通过饮食从高温烹饪的食物或含有大量糖的食物中摄入。本研究旨在综述所有已发表的关于糖尿病患者低饮食 AGE（L-dAGEs）干预的随机对照试验（RCT）。使用适当的关键词在 Pubmed、Scopus 和 Cochrane 数据库中进行搜索（截至 2024 年 2 月 29 日）（纳入标准：RCT、糖尿病患者、年龄>18 岁、与炎症、葡萄糖和脂质相关的结局；排除标准：非 RCTs、病例系列、病例报告和致编辑的信，或动物研究）。本综述已在 Open Science Framework（OSF）上注册。从 7091 项研究中，最终有 7 项研究被纳入。使用更新的 Cochrane 偏倚风险工具评估偏倚。3/3 项研究记录了循环 AGEs 的减少。在 L-dAGEs 饮食后，血糖参数没有特别的差异。在一项研究（1/6）中观察到葡萄糖水平降低，而在任何研究中（0/6 和 0/3）HbA1c 和 HOMA 均未发生变化。血脂谱在一项研究（1/4）中也发生了变化。氧化应激（3/3 项研究中有有益作用）和炎症标志物（4/4 项研究中有有益作用）观察到更一致的结果。还报道了其他动脉保护作用，如脂联素增加。局限性包括样本量小，以及大多数研究没有考虑饮食和体育活动习惯。总之，L-dAGEs 模式可能最大限度地减少 AGEs 的积累，并对氧化应激和炎症指标产生有益影响，而对糖尿病患者的血糖和血脂参数的影响不一致且适度。
