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Carboxymethyl-lysine, an advanced glycation end product, and decline of renal function in older community-dwelling adults

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Abstract

Background

Advanced glycation end products (AGEs) are bioactive molecules found in greater concentrations in foods that have been processed at high temperatures. AGEs have been associated with impaired renal function in diabetes and in uremia. The relationship between AGEs and renal function in community-dwelling adults has not been well characterized.

Aim of the study

The objective was to determine whether plasma AGEs are independently associated with chronic kidney disease (CKD) and predictive of renal function in older adults.

Methods

The relationship between plasma carboxymethyl-lysine (CML), an AGE, and CKD (≥ stage 3 of National Kidney Foundation classification; estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m2) and eGFR at 3- and 6-years follow-up was examined in a population-based study of aging, the InCHIANTI study, in Tuscany, Italy.

Results

Of 1,008 adults, aged ≥65 years, 153 (15.2%) had CKD at enrollment. Mean (standard deviation [S.D.]) plasma CML was 365 (110) ng/ml. Plasma CML was associated with CKD (odds ratio [O.R.] expressed per 1 S.D., 1.53, 95% confidence interval [C.I.] 1.27–1.84, P < 0.0001) in a multivariate logistic regression model, adjusting for potential confounders. Plasma CML was associated with eGFR (β = −2.77, standard error [S.E.] = 0.51, P < 0.0001) at baseline, 3-year (β = −2.54, S.E. = 0.61, P < 0.0001) and 6-year follow-up visits (β = −1.21, S.E. = 0.70, P = 0.08) in multivariate linear regression models, adjusting for potential confounders. The associations between plasma CML and prevalent CKD, eGFR, and eGFR at 3- and 6-year follow-up were significant and nearly unchanged after exclusion of adults with diabetes.

Conclusion

Plasma CML is independently associated with CKD and is an independent predictor of decline in renal function in older community-dwelling adults.

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Acknowledgments

This work was supported by National Institute on Aging Grants R01 AG027012, R01 AG029148 and the Intramural Research Program, National Institute on Aging, NIH. Conflict of interest The authors have no conflict of interest.

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Authors and Affiliations

  1. Johns Hopkins University School of Medicine, 550N. Broadway, Suite 700, Baltimore, MD, 21205, USA

    Richard D. Semba & Kai Sun

  2. Division of Nephrology, Dept. of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Jeffrey C. Fink

  3. Geriatric Unit, Azienda Sanitaria Firenze, Florence, Italy

    Stefania Bandinelli

  4. Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD, USA

    Jack M. Guralnik

  5. Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA

    Luigi Ferrucci

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  1. Richard D. Semba
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  2. Jeffrey C. Fink
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Correspondence to Richard D. Semba.

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Semba, R.D., Fink, J.C., Sun, K. et al. Carboxymethyl-lysine, an advanced glycation end product, and decline of renal function in older community-dwelling adults. Eur J Nutr 48, 38–44 (2009). https://doi.org/10.1007/s00394-008-0757-0

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  • DOI: https://doi.org/10.1007/s00394-008-0757-0

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