Advanced glycation end products are associated with cardiovascular risk in the Mexican population

Association between advanced glycation end products and estimated glomerular filtration rate: a cross-sectional analysis

BACKGROUND

Chronic kidney disease (CKD) is a significant public health concern associated with high morbidity and mortality rates, particularly in populations with type 2 diabetes and hypertension. Advanced glycation end products (AGEs) are implicated in CKD pathogenesis, but their association with the estimated glomerular filtration rate (eGFR) remains unclear. We aimed to assess the associations between AGE levels and the eGFR.

METHODS

We conducted a cross-sectional analysis of baseline data from the Health Workers Cohort Study (2004-2006), which included 1,621 adults. AGE levels were categorized into quartiles, and the eGFR was calculated via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2009 equation. Quantile and logistic regression models were used to assess the associations between AGEs and the eGFR, adjusting for potential confounders.

RESULTS

The median AGE level was 334 µU/ml, and the prevalence of low eGFR (< 60 mL/min/1.73 m²) was 4.7%. Quantile regression analysis revealed a significant reduction in the eGFR, particularly in the 10th percentile. Logistic regression models revealed that a 100 µU/ml increase in AGE level was associated with increased odds of a low eGFR (OR: 1.06, 95% CI: 1.03-1.09). Participants with very high AGE levels had greater odds of having a low eGFR than those in the lowest category did (OR: 2.21, 95% CI: 1.00-4.88).

CONCLUSION

Elevated AGE levels were associated with lower eGFRs and increased odds of low eGFRs. These findings underscore the potential role of AGEs in CKD development and suggest the importance of targeting AGE accumulation for CKD prevention and management in high-risk populations.

The associations between skin advanced glycation end-products and Framingham cardiovascular risk in different age groups

Objective

Advanced glycation end-products (AGEs) may contribute to the pathogenesis of atherosclerotic cardiovascular disease (ASCVD), potentially influencing its development and progression differently at various life stages. This study aimed to elucidate the associations between AGEs and the risk of ASCVD across different age groups.

Methods

In this cross-sectional study, 1,240 subjects were enrolled and divided into three groups (Group Ⅰ, 20-39 years old, n = 468; Group Ⅱ, 40-59 years old, n = 471; Group Ⅲ, 60-79 years old, n = 301). Skin AGEs were measured by skin autofluorescence (SAF). ASCVD risk was assessed by a validated Framingham risk score calculator. Other proven ASCVD risk factors were also measured, including glycosylated hemoglobin, uric acid, lipid profile, homocysteine, and cystatin C.

Results

An increasing trend in skin AGEs was observed from Group Ⅰ to Group Ⅲ. Skin AGEs were significantly associated with ASCVD risk in all subjects (OR 1.029, 95% CI 1.003-1.056, P = 0.018), independent of some of the proven cardiovascular risk factors. This association was particularly significant in individuals aged 40-59 and 60-79 (OR = 1.047, 95% CI: 1.025-1.069; OR = 1.022, 95% CI: 1.002-1.042; both P < 0.05). ROC analysis showed that skin AGEs predicted the diagnosis of medium or high ASCVD risk in the pooled group, Group Ⅱ, and Group Ⅲ.

Conclusion

Our study substantiates that skin AGEs play an important role as an independent risk factor for ASCVD, highlighting their significance beyond traditional risk assessment models, particularly in middle-aged and older populations.

Dietary advanced glycation end products intake, genetic predisposition and risk of coronary heart disease: a prospective study

OBJECTIVE

Dietary advanced glycation end products (AGEs) intake may be associated with coronary heart disease (CHD) risk. We aimed to investigate the association between dietary AGEs intake and CHD risk and to further investigate whether this association could be influenced by genetic risk.

METHODS

Data from UK Biobank were used. Dietary AGEs intake, including Nε-(carboxymethyl) lysine (CML), Nε-(1-Carboxyethyl)-L-lysine (CEL), and Nd-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were calculated by coupling the consumption of food items from 24-hour dietary recall with the dietary AGEs database. Baseline dietary information was first collected through Oxford WebQ 24 h food recall between April 2009 and September 2010. From February 2011 to June 2012, the Oxford WebQ survey was conducted online in four rounds. The association between dietary AGEs and CHD risk was estimated using multivariable-adjusted Cox proportional risk models. The association between dietary AGEs intake and genetic risk with CHD risk was further explored via the multiplicative interaction analyses.

RESULTS

During a median follow-up of 12.2 years, 4,348 participants developed CHD. In the fully adjusted model, a higher intake of dietary AGEs, CML and MG-H1 (highest tertile vs. lowest tertile) was associated with a higher risk of CHD [HR, (95% CI):1.12 (1.03,1.23), 1.15 (1.05,1.26) and 1.10 (1.00,1.20), respectively (all P trend < 0.05)]. Among participants with intermediate to high genetic risk, HRs (95% CI) were 1.63 (1.39, 1.91) and 2.45 (2.10, 2.85) for AGEs, 1.67 (1.42, 1.97) and 2.60 (2.23, 3.02) for CML, 1.48 (1.26 1.74) and 2.34 (2.01, 2.72) for CEL, and 1.64 (1.40, 1.92) and 2.31 (1.99, 2.69) for MG-H1, respectively.

CONCLUSIONS

Higher intakes of dietary AGEs, CML and MG-H1 were associated with an increased risk of coronary heart disease, and there was an interaction between dietary AGEs intake and genetic predisposition on the risk of CHD.

Effect of advanced glycation end-products in a wide range of medical problems including COVID-19

Glycation is a physiological process that determines the aging of the organism, while in states of metabolic disorders it is significantly intensified. High concentrations of compounds such as reducing sugars or reactive aldehydes derived from lipid oxidation, occurring for example in diabetes, atherosclerosis, dyslipidemia, obesity or metabolic syndrome, lead to increased glycation of proteins, lipids and nucleic acids. The level of advanced glycation end-products (AGEs) in the body depends on rapidity of their production and the rate of their removal by the urinary system. AGEs, accumulated in the extracellular matrix of the blood vessels and other organs, cause irreversible changes in the biochemical and biomechanical properties of tissues. As a consequence, micro- and macroangiopathies appear in the system, and may contribute to the organ failure, like kidneys and heart. Elevated levels of AGEs also increase the risk of Alzheimer's disease and various cancers. In this paper, we propose a new classification due to modified amino acid residues: arginyl-AGEs, monolysyl-AGEs and lysyl-arginyl-AGEs and dilysyl-AGEs. Furthermore, we describe in detail the effect of AGEs on the pathogenesis of metabolic and old age diseases, such as diabetic complications, atherosclerosis and neurodegenerative diseases. We summarize the currently available data on the diagnostic value of AGEs and present the AGEs as a therapeutic goal in a wide range of medical problems, including SARS-CoV-2 infection and so-called long COVID.