Association Between Advanced Glycation End Products and Sarcopenia: The Mediating Role of Osteoporosis

Abstract

Context Advanced glycation end products (AGEs) are a group of molecules formed through nonenzymatic reactions. These compounds are associated with several age-related diseases, including sarcopenia and osteoporosis. Objective This work aimed to investigate the relationships between AGEs, osteoporosis, and sarcopenia in community-dwelling older adults. Methods This cross-sectional study included 1991 older adults aged 72.37 ± 5.90 years from China. AGE levels were measured by the AGE Reader device. Bone mineral density was assessed using dual-energy X-ray absorptiometry, and osteoporosis was diagnosed based on a T score of less than −2.5. Sarcopenia was defined as loss of muscle mass plus loss of muscle strength and/or reduced physical performance. Presarcopenia was defined as low muscle mass with normal muscle strength and normal physical performance. Results The prevalence of sarcopenia was 18.5%, and that of osteoporosis was 40.5%. Compared to the lowest AGE quartile, the highest AGE quartile showed a significant association with sarcopenia (odds ratio [OR] 2.42; 95% CI, 1.60-3.66) (P for trend <.001), but not with presarcopenia. Per-SD increase in AGE was associated with higher odds of sarcopenia (OR 1.44; 95% CI, 1.26-1.66). Additionally, in the mediation analysis, when AGEs were treated as a continuous variable (the mediation effect is denoted by Za*Zb = 18.81; 95% CI, 8.07-32.32]—the 95% CI does not contain zero, representing a significant mediating effect) or a categorical variable (the mediating effect is expressed as Zmediation = 3.01 > 1.96, which represents a significant mediating effect), osteoporosis played a partial mediating role in the association between AGEs and sarcopenia. Conclusion Elevated AGEs are associated with sarcopenia but not with presarcopenia. This association was partially mediated by osteoporosis.

Mechanism of traditional Chinese medicine in elderly diabetes mellitus and a systematic review of its clinical application

“…Furthermore, HG levels can lead to osmotic diuresis, and disturbances in calcium-phosphorus metabolism, causing significant loss of trace elements such as calcium and phosphorus, resulting in decreased bone density, decreased levels of bone growth factors and bone remodeling function ( Seyfizadeh et al, 2018 ; Sinnott-Armstrong et al, 2021 ). Poor long-term blood glucose control leads to an increase in AGEs which can also lead to abnormalities in bone organic matter metabolism ( Zhang et al, 2023 ).…”