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

Context: Advanced glycation end products (AGEs) are a group of molecules formed through non-enzymatic reactions. These compounds were associated to several age-related diseases, including sarcopenia and osteoporosis.Objective: To investigate the relationships between AGEs, osteoporosis, and sarcopenia in community-dwelling older adults.Materials and methods: This cross-sectional study included 1991 older adults aged 72.37 +/- 5.90 years from China. AGE levels were measured by AGE ReaderTM device. Bone mineral density was assessed using dual-energy X-ray absorptiometry, and osteoporosis was diagnosed based on a T score < -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 (OR 2.42, 95% CI [1.60, 3.66]) (P for trend <0.001), but not with presarcopenia. Per standard deviation(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.Conclusions: Elevated AGEs are associated with sarcopenia but not with presarcopenia. This association was partially mediated by osteoporosis.

Automated summary

This study found that elevated levels of AGEs are associated with sarcopenia, but not with presarcopenia. Osteoporosis plays a partial mediating role in the association between AGEs and sarcopenia.