Habitual intake of advanced glycation endproducts is not associated with worse insulin sensitivity, worse beta cell function, or presence of prediabetes or type 2 diabetes: The Maastricht Study

Armand M A Linkens; Simone J M P Eussen; Alfons J H M Houben; Andrea Mari; Pieter C Dagnelie; Coen D A Stehouwer; Casper G Schalkwijk

doi:10.1016/j.clnu.2023.05.021

Habitual intake of advanced glycation endproducts is not associated with worse insulin sensitivity, worse beta cell function, or presence of prediabetes or type 2 diabetes: The Maastricht Study

Clin Nutr. 2023 Aug;42(8):1491-1500. doi: 10.1016/j.clnu.2023.05.021. Epub 2023 May 29.

Authors

Armand M A Linkens¹, Simone J M P Eussen², Alfons J H M Houben¹, Andrea Mari³, Pieter C Dagnelie⁴, Coen D A Stehouwer¹, Casper G Schalkwijk⁵

Affiliations

¹ Department of Internal Medicine, Maastricht University Medical Center, 6229ER, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, 6229ER, Maastricht, the Netherlands.
² CARIM School for Cardiovascular Diseases, Maastricht University, 6229ER, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, 6229HA, Maastricht, the Netherlands; CAPHRI School for Care and Public Health Research Unit, Maastricht University, 6229ER, Maastricht the Netherlands.
³ Institute of Neuroscience, National Research Council, 35131, Padova, PD, Padua, Italy.
⁴ Department of Epidemiology, Maastricht University, 6229HA, Maastricht, the Netherlands.
⁵ Department of Internal Medicine, Maastricht University Medical Center, 6229ER, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, 6229ER, Maastricht, the Netherlands. Electronic address: C.Schalkwijk@maastrichtuniversity.nl.

PMID: 37302878
DOI: 10.1016/j.clnu.2023.05.021

Abstract

Background & aims: A diet high in advanced glycation endproducts (AGEs) is a potential risk factor for insulin resistance, beta cell dysfunction, and ultimately type 2 diabetes. We investigated associations between habitual intake of dietary AGEs and glucose metabolism in a population-based setting.

Methods: In 6275 participants of The Maastricht Study (mean ± SD age: 60 ± 9, 15.1% prediabetes and 23.2% type 2 diabetes), we estimated habitual intake of dietary AGEs N^ε-(carboxymethyl)lysine (CML), N^ε-(1-carboxyethyl)lysine (CEL), and N^δ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) by combining a validated food frequency questionnaire (FFQ) with our mass-spectrometry dietary AGE database. We determined insulin sensitivity (Matsuda- and HOMA-IR index), beta cell function (C-peptidogenic index, glucose sensitivity, potentiation factor, and rate sensitivity), glucose metabolism status, fasting glucose, HbA1c, post-OGTT glucose, and OGTT glucose incremental area under the curve. Cross-sectional associations between habitual AGE intake and these outcomes were investigated using a combination of multiple linear regression and multinomial logistic regression adjusting for several potential confounders (demographic, cardiovascular, and lifestyle factors).

Results: Generally, higher habitual intake of AGEs was not associated with worse indices of glucose metabolism, nor with increased presence of prediabetes or type 2 diabetes. Higher dietary MG-H1 was associated with better beta cell glucose sensitivity.

Conclusions: The present study does not support an association of dietary AGEs with impaired glucose metabolism. Whether higher intake of dietary AGEs translates to increased incidence of prediabetes or type 2 diabetes on the long term should be investigated in large prospective cohort studies.

Keywords: Beta cell function; Dietary advanced glycation endproducts; Glucose metabolism; Insulin sensitivity; Population-based observational cohort.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Diabetes Mellitus, Type 2* / epidemiology
Dietary Advanced Glycation End Products
Glucose
Glycation End Products, Advanced
Humans
Insulin Resistance*
Prediabetic State* / epidemiology
Prospective Studies

Substances

Glycation End Products, Advanced
Glucose
Dietary Advanced Glycation End Products