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.
Study Goal
The researchers aimed to determine whether modulating AGE metabolism through specific diets (Mediterranean vs. low-fat) could delay kidney function decline in T2DM patients with coronary heart disease.
Results Summary
The Mediterranean diet resulted in a slower decline of eGFR compared to the low-fat diet in patients with mildly decreased eGFR, reduced MG levels, and increased GloxI expression. Higher MG levels post-intervention were associated with a greater probability of eGFR decline.
Population
T2DM patients with coronary heart disease and eGFR ≥ 30 ml/min/1.73 m² (n=540 from the CORDIOPREV study).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mediterranean diet | decrease | eGFR | patients with mildly decreased eGFR | - | produced a lower declined of eGFR | #1 |
Mediterranean diet | decrease | MG levels | normal and mildly decreased eGFR patients | - | was able to decrease MG levels | #2 |
Mediterranean diet | increase | GloxI expression | normal and mildly decreased eGFR patients | - | increase GloxI expression | #3 |
dietary intervention | increase | probability of eGFR decline | - | 6.8-fold (95 % CI 0.039;0.554) | One standard deviation increment of MG levels resulted in a higher probability of eGFR decline | #4 |
Mediterranean diet | neutral | kidney function | T2DM patients with CHD | - | lowering circulating AGE levels, specifically MG, might be linked to the preservation of kidney function | #5 |
Mediterranean diet | decrease | eGFR | T2DM patients with CHD | - | decreased decline of eGFR | #6 |
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 m 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.