Dietary advanced glycation end products are associated with an increased risk of non-alcoholic fatty liver disease in Iranian adults

Heat-Processed Diet Rich in Advanced Glycation End Products Induced the Onset and Progression of NAFLD via Disrupting Gut Homeostasis and Hepatic Lipid Metabolism

Epidemiologic studies have suggested an association between the consumption of dietary advanced glycation end products (dAGEs) and the incidence of nonalcoholic fatty liver disease (NAFLD). However, the precise mechanism by which dAGEs induce NAFLD development, particularly the pathogenic role of the gut-liver axis, remains poorly understood. In this study, by establishing a high-AGE diet (HAD)-fed C57BL/6 mouse model, we employed multiomics approaches combined with a series of biological analyses to investigate the effect of HAD on NAFLD in vivo. Our results showed that exposure to HAD led to fat accumulation, oxidative stress, inflammation, and fibrosis in the liver of mice. Transcriptome analysis further revealed that HAD exposure disrupted lipid metabolism and activated inflammation-related signaling pathways in the liver. Additionally, exposure to HAD induced perturbations in gut homeostasis, as evidenced by the compromised gut barrier function, reduced probiotic abundance, and increases in pathogenic bacterial proportions. Dysbiosis of gut homeostasis may further act as a trigger for the initiation and progression of NAFLD via the gut-liver axis. This study sheds light on the underlying mechanisms through which dAGEs contribute to the development of NAFLD and helps to understand the detrimental effects of food ultraprocessing products in modern diets. Future studies are needed to explore the in-depth mechanisms related to the gut-liver axis to consolidate our conclusions.

Monascus pigments suppress fructose-mediated BSA glycation by trapping methylglyoxal and covalent binding to proteins

In this study, four Monascus pigments (ankaflavin, AK; monascin MS; rubropunctatin, O1; monascorubrin, O2) were proved to exhibit considerable anti-glycation properties in bovine serum albumin (BSA)-fructose model. AK (40.62 %) and MS (48.38 %) were found to exert lower inhibitory effects on the formation of fluorescent advanced glycation end products (AGEs) than aminoguanidine (59.4 %), while O1 (90.64 %) and O2 (93.82 %) displayed much stronger abilities. AK and MS could trap methylglyoxal (MGO) with maximum capture rates of 85.67 % and 84.90 %, respectively, and only mono-MGO adducts of them were detected. LC-Orbitrap MS/MS analysis revealed that four pigments significantly altered the type and reduced the number of the glycated sites and they all covalently bound to BSA, with O1 and O2 possessing high reactivity. Altogether, AK and MS suppressed fluorescent AGEs formation mainly via trapping MGO and covalently interacting with BSA, and blocking free amino groups was the dominant mechanism for O1 and O2. These findings presented new insights into Monascus pigments as dietary supplement for inhibiting protein glycation.

The association of the healthy food diversity index with the risk of non-alcoholic fatty liver disease among the adult population

BACKGROUND AND AIM

Dietary diversity index is a useful evaluation index for examining the role of dietary pattern in predicting chronic diseases risk, including non-alcoholic fatty liver disease(NAFLD). In the present study, we aimed to examine the possible association of dietary diversity using US Healthy Food Diversity(US HFD) index and the NAFLD risk in Iranian adults.

METHODS

A total of 675 individuals (225 patients with NAFLD and 450 controls) aged 20-60 years were recruited for the current case-control study. Data on dietary intakes were determined using a validated food frequency questionnaire, and dietary diversity was calculated using the US HFD index. In patients with NAFLD, an ultrasound scan of the liver was used to detect NAFLD. Logistic regression models were used to estimate the odds ratios(ORs) and 95 % confidence interval(CI) of NAFLD across tertiles of the US HFD index.

RESULTS

Mean ± SD age of the study population were 38.13 ± 8.85 years. The median (interquartile) score of the US HFD index in patients with NAFLD and healthy subjects was 0.08(0.07-0.09) and 0.09(0.08-0.10), respectively. In the age and sex-adjusted model, the odds of NAFLD were considerably reduced across tertiles of the US HFD index (OR:0.48; 95%CI:0.32-0.72, Ptrend<0.001). Also, in the final model, after adjusting for age, sex, waist-to-hip ratio, smoking, physical activity, marital status, socioeconomic status, and energy intake, the odds of NAFLD were significantly reduced across tertiles US HFD index (OR:0.55; 95%CI:0.31-0.97, Ptrend<0.001). Furthermore, for each SD increase in the US HFD index, the odds of NAFLD are reduced by 23 % (OR:0.77;95%CI:0.60-0.97,P-Value<0.001).

CONCLUSIONS

Our findings revealed that greater adherence to dietary pattern with a high US HFD score, defined by higher intakes of fruits, vegetables, whole grains, legumes, nuts, low-fat dairy, seeds, soya products, and plant oils may be related to reducing the odds of NAFLD.

Ultra-processed food consumption and non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance: A systematic review

Background

High ultra-processed food (UPF) consumption is associated with the development of various diet-related non-communicable diseases, especially obesity and type 2 diabetes. The present study aimed to systematically review the association between UPF consumption and non-alcoholic fatty liver disease (NAFLD) and its leading risk factors; metabolic syndrome (MetS) and insulin resistance (IR).

Methods

A comprehensive search was conducted in PubMed, Scopus, Embase, Web of Science, CINAHL, and Cochrane (March 2023), and references of the identified articles were checked. The search keywords were defined through an exploratory investigation in addition to MeSH and similarly controlled vocabulary thesauruses. Observational and interventional studies were included. Studies that focused only on specific groups of processed foods or overlapping dietary patterns were excluded. The quality assessment was conducted using the Joanna Briggs Institute's critical appraisal tools for observational studies and Cochrane's risk of bias 2 tool for randomized-control trials. A narrative synthesis was employed to report the results.

Results

Fifteen studies were included, with a total of 52,885 participants, one randomized-controlled trial, and fourteen observational studies (nine cross-sectional and five prospective). The review has shown a significant association between UPF consumption and NAFLD in three studies out of six, MetS in five out of eight, and IR in one out of three. All large-scale prospective cohorts that studied NAFLD or MetS outcomes demonstrated a positive association. In contrast, studies that did not demonstrate significant associations were mostly cross-sectional and small. The evidence for an association with IR was insufficient and conflicting.

Conclusion

The included studies are few, observational, and based upon self-reported dietary assessment tools. However, current evidence indicates that UPF is not only associated with obesity and type 2 diabetes but may also be a risk factor for NAFLD and MetS. UPF is a worldwide concern deserving further longitudinal research.

Impact and implications

Overconsumption of ultra-processed food (UPF) may lead to the development of obesity and type 2 diabetes, but the association with non-alcoholic fatty liver disease (NAFLD) is not well established. The present systematic review shows that UPF may be associated with NAFLD, although more large prospective studies are needed. These findings emphasize the importance of minimizing the consumption of UPF to prevent NAFLD and other metabolic diseases among the general adult population. This systematic review and further prospective studies, epidemiological or interventional, can help physicians provide patients with evidence-based nutritional recommendations and will support policymakers in restricting the marketing of UPF as well as promoting affordable, healthy, and minimally processed foods.

Oxidative Stress in Health and Disease

Oxidative stress, resulting from the excessive intracellular accumulation of reactive oxygen species (ROS), reactive nitrogen species (RNS), and other free radical species, contributes to the onset and progression of various diseases, including diabetes, obesity, diabetic nephropathy, diabetic neuropathy, and neurological diseases, such as Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), and Parkinson's disease (PD). Oxidative stress is also implicated in cardiovascular disease and cancer. Exacerbated oxidative stress leads to the accelerated formation of advanced glycation end products (AGEs), a complex mixture of crosslinked proteins and protein modifications. Relatively high levels of AGEs are generated in diabetes, obesity, AD, and other I neurological diseases. AGEs such as Ne-carboxymethyllysine (CML) serve as markers for disease progression. AGEs, through interaction with receptors for advanced glycation end products (RAGE), initiate a cascade of deleterious signaling events to form inflammatory cytokines, and thereby further exacerbate oxidative stress in a vicious cycle. AGE inhibitors, AGE breakers, and RAGE inhibitors are therefore potential therapeutic agents for multiple diseases, including diabetes and AD. The complexity of the AGEs and the lack of well-established mechanisms for AGE formation are largely responsible for the lack of effective therapeutics targeting oxidative stress and AGE-related diseases. This review addresses the role of oxidative stress in the pathogenesis of AGE-related chronic diseases, including diabetes and neurological disorders, and recent progress in the development of therapeutics based on antioxidants, AGE breakers and RAGE inhibitors. Furthermore, this review outlines therapeutic strategies based on single-atom nanozymes that attenuate oxidative stress through the sequestering of reactive oxygen species (ROS) and reactive nitrogen species (RNS).