Urinary excretion of fluorescent advanced glycation end products (AGEs) in the elderly

Association between Urinary Advanced Glycation End Products and Subclinical Inflammation in Children and Adolescents: Results from the Italian I.Family Cohort

Advanced Glycation End Products (AGEs) have been positively correlated with inflammation in adults, while inconsistent evidence is available in children. We evaluated the association between urinary AGEs, measured by fluorescence spectroscopy, and biomarkers of subclinical inflammation in 676 healthy children/adolescents (age 11.8 ± 1.6 years, M ± SD) from the Italian cohort of the I.Family project. Urinary fluorescent AGEs were used as independent variable and high-sensitivity C-reactive protein (hs-CRP) was the primary outcome, while other biomarkers of inflammation were investigated as secondary outcomes. Participants with urinary AGEs above the median of the study population showed statistically significantly higher hs-CRP levels as compared to those below the median (hs-CRP 0.44 ± 1.1 vs. 0.24 ± 0.6 mg/dL, M ± SD p = 0.002). We found significant positive correlations between urinary AGEs and hs-CRP (p = 0.0001), IL-15 (p = 0.001), IP-10 (p = 0.006), and IL-1Ra (p = 0.001). At multiple regression analysis, urinary AGEs, age, and BMI Z-score were independent variables predicting hs-CRP levels. We demonstrated for the first time, in a large cohort of children and adolescents, that the measurement of fluorescent urinary AGEs may represent a simple, noninvasive, and rapid technique to evaluate the association between AGEs and biomarkers of inflammation. Our data support a role of AGEs as biomarkers of subclinical inflammation in otherwise healthy children and adolescents.

Dietary intake of advanced glycation endproducts and risk of hepatobiliary cancers: A multinational cohort study

Advanced glycation endproducts (AGEs) may contribute to liver carcinogenesis because of their proinflammatory and prooxidative properties. Diet is a major source of AGEs, but there is sparse human evidence on the role of AGEs intake in liver cancer etiology. We examined the association between dietary AGEs and the risk of hepatobiliary cancers in the European Prospective Investigation into Cancer and Nutrition prospective cohort (n = 450 111). Dietary intake of three AGEs, Nε -[carboxymethyl]lysine (CML), Nε -[1-carboxyethyl]lysine (CEL) and Nδ -[5-hydro-5-methyl-4-imidazolon-2-yl]-ornithine (MG-H1), was estimated using country-specific dietary questionnaires linked to an AGEs database. Cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations between dietary AGEs and risk of hepatocellular carcinoma (HCC), gallbladder and biliary tract cancers were estimated using multivariable Cox proportional hazard regression. After a median follow-up time of 14.9 years, 255 cases of HCC, 100 cases of gallbladder cancer and 173 biliary tract cancers were ascertained. Higher intakes of dietary AGEs were inversely associated with the risk of HCC (per 1 SD increment, HR-CML  = 0.87, 95% CI: 0.76-0.99, HR-CEL  = 0.84, 95% CI: 0.74-0.96 and HR-MH-G1  = 0.84, 95% CI: 0.74-0.97). In contrast, positive associations were observed with risk of gallbladder cancer (per 1 SD, HR-CML  = 1.28, 95% CI: 1.05-1.56, HR-CEL  = 1.17; 95% CI: 0.96-1.40, HR-MH-G1  = 1.27, 95% CI: 1.06-1.54). No associations were observed for cancers of the intra and extrahepatic bile ducts. Our findings suggest that higher intakes of dietary AGEs are inversely associated with the risk of HCC and positively associated with the risk of gallbladder cancer.

The fate of dietary advanced glycation end products in the body: from oral intake to excretion

Advanced glycation end products (AGEs), which are closely associated with various chronic diseases, are formed through the Maillard reaction when aldehydes react with amines in heated foods or in living organisms. The fate of dietary AGEs after oral intake plays a crucial role in regulating the association between dietary AGEs and their biological effects. However, the complexity and diversity of dietary AGEs make their fate ambiguous. Glycated modifications can impair the digestion, transport and uptake of dietary AGEs. High and low molecular weight AGEs may exhibit individual differences in their distribution, metabolism and excretion. Approximately 50-60% of free AGEs are excreted after dietary intake, whereas protein-bound AGEs exhibit a limited excretion rate. In this article, we summarize several AGE classification criteria and their abundance in foods, and in the body. A standardized static in vitro digestion method is strongly recommended to obtain comparable results of AGE digestibility. Sophisticated hypotheses regarding the intestinal transportation and absorption of drugs, as well as calculated physicochemical parameters, are expected to alleviate the difficulties determining the digestion, transport and uptake of dietary AGEs. Orally supplied AGEs with low or high molecular weights must be supported by well-defined amounts in investigations of excretion. Furthermore, unequivocal evidence should be obtained regarding the degradation and metabolism products of dietary AGEs.

Associations between Urinary Advanced Glycation End Products and Cardiometabolic Parameters in Metabolically Healthy Obese Women

Advanced glycation end products (AGEs) have been implicated in the pathophysiology of type 2 diabetes and cardiovascular disease. We aimed to determine the associations of urinary carboxymethyl-lysine (CML) and methylglyoxal-hydroimidazolone (MG-H1) levels with cardiometabolic parameters in metabolically healthy obese women. Anthropometric, glycemic, cardiovascular, and urinary AGE parameters were measured in 58 metabolically healthy obese women (age: 39.98 ± 8.72 years; body mass index (BMI): 32.29 ± 4.05 kg/m²). Urinary CML levels were positively associated with BMI (r = 0.29, p = 0.02). After adjustment for age and BMI, there was a trend for positive associations between urinary CML levels and fasting (p = 0.06) and 2 h insulin (p = 0.05) levels, and insulin resistance measured by homeostatic model assessment (HOMA-IR) (p = 0.06). Urinary MG-H1 levels were positively associated with systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and total and low-density lipoprotein cholesterol after adjustment for age, BMI, and HOMA-IR (all p ˂ 0.05). There were no associations between urinary CML levels and cardiovascular parameters, and between urinary MG-H1 levels and glycemic measurements. Our data support a role of urinary AGEs in the pathophysiology of insulin resistance and cardiovascular disease; however, future studies are highly warranted.

Effects of diets supplemented with MRPs from bread crust on the food intake and body weights in rats

Traditionally the effects of dietary Maillard reaction products (MRPs) on food intake and body weight have been described in different studies, but few investigations have been conducted to analyse the main contributors responsible. We studied the effects of long-term consumption of MRPs from bread crust (BC) on rat growth, investigating the efficiency of diet and protein utilization. Different soluble and insoluble fractions of BC were studied to analyse the possible contributors. Additionally, the colour of the faecal material and the amount of fluorescent MRPs in the urine were measured in order to demonstrate MRP excretion. Six groups of rats were fed the following diets for 88 days: control (AIN-93G diet); bread dough (BD) and BC (containing 10% of BD or BC, respectively); low and high molecular weight (LMW-HMW) (containing soluble compounds from BC with <5 kDa and >5 kDa, respectively); insoluble (containing insoluble compounds from BC). Dietary MRPs tended to reduce the food intake and body weight significantly after consumption of more complex compounds (HMW and insoluble). The L*-value in the faeces decreased in animals fed BC and its derivatives, providing evidence of the presence of MRPs. The fluorescence associated with MRP excretion in urine was higher when the LMW diet was consumed, suggesting the easier absorption and clearance of the smaller compounds of BC.