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A 4-week high-AGE diet does not impair glucose metabolism and vascular function in obese individuals.

Abstract
BACKGROUNDAccumulation of advanced glycation endproducts (AGEs) may contribute to the pathophysiology of type 2 diabetes and its vascular complications. AGEs are widely present in food, but whether restricting AGE intake improves risk factors for type 2 diabetes and vascular dysfunction is controversial.METHODSAbdominally obese but otherwise healthy individuals were randomly assigned to a specifically designed 4-week diet low or high in AGEs in a double-blind, parallel design. Insulin sensitivity, secretion, and clearance were assessed by a combined hyperinsulinemic-euglycemic and hyperglycemic clamp. Micro- and macrovascular function, inflammation, and lipid profiles were assessed by state-of-the-art in vivo measurements and biomarkers. Specific urinary and plasma AGEs Nε-(carboxymethyl)lysine (CML), Nε-(1-carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were assessed by mass spectrometry.RESULTSIn 73 individuals (22 males, mean ± SD age and BMI 52 ± 14 years, 30.6 ± 4.0 kg/m2), intake of CML, CEL, and MG-H1 differed 2.7-, 5.3-, and 3.7-fold between the low- and high-AGE diets, leading to corresponding changes of these AGEs in urine and plasma. Despite this, there was no difference in insulin sensitivity, secretion, or clearance; micro- and macrovascular function; overall inflammation; or lipid profile between the low and high dietary AGE groups (for all treatment effects, P > 0.05).CONCLUSIONThis comprehensive RCT demonstrates very limited biological consequences of a 4-week diet low or high in AGEs in abdominally obese individuals.TRIAL REGISTRATIONClinicaltrials.gov, NCT03866343; trialregister.nl, NTR7594.FUNDINGDiabetesfonds and ZonMw.
AuthorsArmand Ma Linkens, Alfons Jhm Houben, Petra M Niessen, Nicole Eg Wijckmans, Erica Ec de Goei, Mathias Dg Van den Eynde, Jean Ljm Scheijen, Marjo Ph van den Waarenburg, Andrea Mari, Tos Tjm Berendschot, Lukas Streese, Henner Hanssen, Martien Cjm van Dongen, Christel Cjaw van Gool, Coen DA Stehouwer, Simone Jmp Eussen, Casper G Schalkwijk
JournalJCI insight (JCI Insight) Vol. 7 Issue 6 (03 22 2022) ISSN: 2379-3708 [Electronic] United States
PMID35133989 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Glycation End Products, Advanced
  • Lipids
  • Glucose
  • Lysine
Topics
  • Diabetes Mellitus, Type 2
  • Diet
  • Glucose
  • Glycation End Products, Advanced
  • Humans
  • Inflammation
  • Insulin Resistance
  • Lipids
  • Lysine
  • Male
  • Obesity

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