Modulation of circulating levels of advanced glycation end products and its impact on intima-media thickness of both common carotid arteries: CORDIOPREV randomised controlled trial.
Study Goal
The researchers aimed to determine whether the Mediterranean diet's reduction in atherosclerosis progression is associated with modulation of circulating AGE levels in coronary heart disease (CHD) patients.
Results Summary
The Mediterranean diet improved AGE metabolism (increased AGER1 and GloxI gene expression, GSH, and sRAGE levels) and better managed circulating AGE levels compared to a low-fat diet, potentially reducing atherosclerosis progression in CHD patients.
Population
1002 patients with coronary heart disease (CHD).
Effective Dosage
Not specified
Duration
5 years
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mediterranean diet | no change | MG levels | patients with coronary heart disease (CHD) | - | did not affect | #1 |
low-fat diet | increase | MG levels | patients with coronary heart disease (CHD) | - | significantly increased | #2 |
Mediterranean diet | decrease | MG levels | patients with coronary heart disease (CHD) | - | leading to lower | #3 |
Mediterranean diet | increase | AGE metabolism | Non-increased IMT-CC patients | - | produced an upregulation | #4 |
Mediterranean diet | increase | AGER1 gene expression | Non-increased IMT-CC patients | - | increased | #5 |
Mediterranean diet | increase | GloxI gene expression | Non-increased IMT-CC patients | - | increased | #6 |
Mediterranean diet | increase | GSH levels | Non-increased IMT-CC patients | - | increased | #7 |
Mediterranean diet | increase | sRAGE levels | Non-increased IMT-CC patients | - | increased | #8 |
Mediterranean diet | increase | MG levels | Increased IMT-CC patients | - | increased | #9 |
Mediterranean diet | increase | MG levels | Increased IMT-CC patients | - | this increment was lower | #10 |
Mediterranean diet | decrease | atherosclerosis | patients with CHD | - | reduces the progression | #11 |
BACKGROUND: Increasing evidence supports the role of advanced glycation end products (AGEs) in atherosclerosis in both diabetic and non-diabetic patients, suggesting that therapeutic strategies targeting AGEs may offer potential benefits in this population. The Mediterranean diet is associated with improved biomarkers and anthropometric measurements related with atherosclerosis in addition to its ability to modulate AGE metabolism. Our aim was to determine whether the reduction in atherosclerosis progression (measured by changes in intima-media thickness of both common carotid arteries (IMT-CC)), observed after consumption of a Mediterranean diet compared to a low-fat diet, is associated with a modulation of circulating AGE levels in patients with coronary heart disease (CHD). METHODS: 1002 CHD patients were divided in: (1) Non-increased IMT-CC patients, whose IMT-CC was reduced or not changed after dietary intervention and (2) Increased IMT-CC patients, whose IMT-CC was increased after dietary intervention. Serum AGE levels (methylglyoxal-MG and Nε-Carboxymethyllysine-CML) and parameters related to AGE metabolism (AGER1 and GloxI mRNA and sRAGE levels) and reduced glutathione (GSH) levels were measured before and after 5-years of dietary intervention. RESULTS: The Mediterranean diet did not affect MG levels, whereas the low-fat diet significantly increased them compared to baseline (p = 0.029), leading to lower MG levels following the Mediterranean diet than the low-fat diet (p < 0.001). The Mediterranean diet, but not the low-fat diet, produced an upregulation of AGE metabolism, with increased AGER1 and GloxI gene expression as well as increased GSH and sRAGE levels in Non-increased IMT-CC patients (all p < 0.05). Although the Mediterranean diet increased MG levels in Increased IMT-CC patients, this increment was lower compared to the low-fat diet (all p < 0.05). CONCLUSIONS: Our results suggest that an improvement in modulation of AGE metabolism, which facilitates better management of circulating AGE levels, may be one of the mechanisms through which the Mediterranean diet, compared to a low-fat diet, reduces the progression of atherosclerosis in patients with CHD. Trial registration https://clinicaltrials.gov/ct2/show/NCT00924937 , Clinicaltrials.gov number, NCT00924937.