Francisco M. Gutierrez-Mariscal , Alicia Podadera-Herreros , Juan F. Alcalá-Diaz , Magdalena P. Cardelo , Antonio P. Arenas-de Larriva , Silvia de la Cruz-Ares , Jose D. Torres-Peña , Raul M. Luque , Pablo Perez-Martinez , Javier Delgado-Lista , Jose Lopez-Miranda , Elena M. Yubero-Serrano
{"title":"地中海饮食降低循环中的甲基乙二酸水平与 2 型糖尿病和冠心病患者肾功能的保护有关：来自 CORDIOPREV 随机对照试验的结论","authors":"Francisco M. Gutierrez-Mariscal , Alicia Podadera-Herreros , Juan F. Alcalá-Diaz , Magdalena P. Cardelo , Antonio P. Arenas-de Larriva , Silvia de la Cruz-Ares , Jose D. Torres-Peña , Raul M. Luque , Pablo Perez-Martinez , Javier Delgado-Lista , Jose Lopez-Miranda , Elena M. Yubero-Serrano","doi":"10.1016/j.diabet.2023.101503","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>Advanced glycation end products (AGEs) play a role in kidney disease in type 2 diabetes mellitus (T2DM). However, there have been no prior controlled clinical trials examining the effects of specific diets on AGE metabolism and their impact on kidney function. Our aim was to assess whether modulating AGE metabolism resulting in reduced AGEs levels, after consumption of two healthy diets, could delay kidney function decline in patients with T2DM and coronary heart disease (CHD).</p></div><div><h3>Methods</h3><p>T2DM patients (540 out of 1002 patients from the CORDIOPREV study), with estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m<sup>2</sup>, were classified based on their baseline kidney function: normal eGFR (≥ 90 ml/min/1.73 m<sup>2</sup>), mildly decreased eGFR (60- < 90 ml/min/1.73 m<sup>2</sup>) and moderately decreased eGFR (<60 ml/min/1.73 m<sup>2</sup>). Serum AGE levels, methylglyoxal (MG) and N-carboximethyllysine (CML), and gene expression related to AGE metabolism (<em>AGER1, RAGE</em>, and <em>GloxI</em> mRNA) were measured before and after 5-years of dietary intervention (a Mediterranean diet or a low-fat diet).</p></div><div><h3>Results</h3><p>Mediterranean diet produced a lower declined of eGFR compared to the low-fat diet only in patients with mildly decreased eGFR (<em>P</em> = 0.035). Moreover, Mediterranean diet was able to decrease MG levels and increase <em>GloxI</em> expression in normal and mildly decreased eGFR patients (all <em>P</em> < 0.05). One standard deviation increment of MG levels after dietary intervention resulted in a 6.8-fold (95 % CI 0.039;0.554) higher probability of eGFR decline.</p></div><div><h3>Conclusion</h3><p>Our study showed that lowering circulating AGE levels, specifically MG, after following a Mediterranean diet, might be linked to the preservation of kidney function, evidenced by a decreased decline of eGFR in T2DM patients with CHD. Patients with mildly decreased eGFR could potentially benefit more from AGE reduction in maintaining kidney function.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S126236362300085X/pdfft?md5=90da1a438dd19cd356bb2859e6308063&pid=1-s2.0-S126236362300085X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Reduction of circulating methylglyoxal levels by a Mediterranean diet is associated with preserved kidney function in patients with type 2 diabetes and coronary heart disease: From the CORDIOPREV randomized controlled trial\",\"authors\":\"Francisco M. Gutierrez-Mariscal , Alicia Podadera-Herreros , Juan F. Alcalá-Diaz , Magdalena P. Cardelo , Antonio P. Arenas-de Larriva , Silvia de la Cruz-Ares , Jose D. Torres-Peña , Raul M. 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Our aim was to assess whether modulating AGE metabolism resulting in reduced AGEs levels, after consumption of two healthy diets, could delay kidney function decline in patients with T2DM and coronary heart disease (CHD).</p></div><div><h3>Methods</h3><p>T2DM patients (540 out of 1002 patients from the CORDIOPREV study), with estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m<sup>2</sup>, were classified based on their baseline kidney function: normal eGFR (≥ 90 ml/min/1.73 m<sup>2</sup>), mildly decreased eGFR (60- < 90 ml/min/1.73 m<sup>2</sup>) and moderately decreased eGFR (<60 ml/min/1.73 m<sup>2</sup>). Serum AGE levels, methylglyoxal (MG) and N-carboximethyllysine (CML), and gene expression related to AGE metabolism (<em>AGER1, RAGE</em>, and <em>GloxI</em> mRNA) were measured before and after 5-years of dietary intervention (a Mediterranean diet or a low-fat diet).</p></div><div><h3>Results</h3><p>Mediterranean diet produced a lower declined of eGFR compared to the low-fat diet only in patients with mildly decreased eGFR (<em>P</em> = 0.035). Moreover, Mediterranean diet was able to decrease MG levels and increase <em>GloxI</em> expression in normal and mildly decreased eGFR patients (all <em>P</em> < 0.05). One standard deviation increment of MG levels after dietary intervention resulted in a 6.8-fold (95 % CI 0.039;0.554) higher probability of eGFR decline.</p></div><div><h3>Conclusion</h3><p>Our study showed that lowering circulating AGE levels, specifically MG, after following a Mediterranean diet, might be linked to the preservation of kidney function, evidenced by a decreased decline of eGFR in T2DM patients with CHD. 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Reduction of circulating methylglyoxal levels by a Mediterranean diet is associated with preserved kidney function in patients with type 2 diabetes and coronary heart disease: From the CORDIOPREV randomized controlled trial
Aim
Advanced glycation end products (AGEs) play a role in kidney disease in type 2 diabetes mellitus (T2DM). However, there have been no prior controlled clinical trials examining the effects of specific diets on AGE metabolism and their impact on kidney function. Our aim was to assess whether modulating AGE metabolism resulting in reduced AGEs levels, after consumption of two healthy diets, could delay kidney function decline in patients with T2DM and coronary heart disease (CHD).
Methods
T2DM patients (540 out of 1002 patients from the CORDIOPREV study), with estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m2, were classified based on their baseline kidney function: normal eGFR (≥ 90 ml/min/1.73 m2), mildly decreased eGFR (60- < 90 ml/min/1.73 m2) and moderately decreased eGFR (<60 ml/min/1.73 m2). Serum AGE levels, methylglyoxal (MG) and N-carboximethyllysine (CML), and gene expression related to AGE metabolism (AGER1, RAGE, and GloxI mRNA) were measured before and after 5-years of dietary intervention (a Mediterranean diet or a low-fat diet).
Results
Mediterranean diet produced a lower declined of eGFR compared to the low-fat diet only in patients with mildly decreased eGFR (P = 0.035). Moreover, Mediterranean diet was able to decrease MG levels and increase GloxI expression in normal and mildly decreased eGFR patients (all P < 0.05). One standard deviation increment of MG levels after dietary intervention resulted in a 6.8-fold (95 % CI 0.039;0.554) higher probability of eGFR decline.
Conclusion
Our study showed that lowering circulating AGE levels, specifically MG, after following a Mediterranean diet, might be linked to the preservation of kidney function, evidenced by a decreased decline of eGFR in T2DM patients with CHD. Patients with mildly decreased eGFR could potentially benefit more from AGE reduction in maintaining kidney function.
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A high quality scientific journal with an international readership
Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing.
Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.
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