INCREASED LEVELS OF ADVANCED GLYCATION END PRODUCTS ARE ASSOCIATED WITH HIGHER AORTIC STIFFNESS IN YOUNGER INDIVIDUALS OF THE GENERAL POPULATION

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Objective: Advanced Glycation End products (AGEs) is an established risk marker in diabetic vascular disease, and associated with the degree of diabetes complications, renal failure, and atherosclerosis in older individuals. The relationship between aortic stiffness and AGEs has not been thoroughly examined in the younger population. We aimed to evaluate the association between AGEs and aortic stiffness in the general population of young and mid-aged adults with few comorbidities. Design and method: We cross-sectionally analysed 2518 participants from a prospective population-based cohort (mean age 41.8±14.5 years, 52.2% women). Advanced glycation end-products were measured as skin autofluorescence with AGE-Reader™, which is a well-validated, non-invasive method. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (cf-PWV) and augmentation index adjusted for resting heart rate (Aix) at the arteria radialis using SphygmoCor®. Linear regression stratified by age equal to or below 50 years (n = 1689) and 51 years and above (n = 829) was used to analyse associations between AGEs, and PWV and Aix in a univariate model and multivariable model adjusted for sex, body mass index, systolic blood pressure, heart rate, fasting glucose, estimated glomerular filtration rate, low-density-lipoprotein, and current smoking. Results: Mean cf-PWV and Aix across quartiles of AGEs in both age groups are shown in Figure 1. We found that one unit increase in skin autofluorescence was significantly associated with direct aortic stiffness (cf-PWV) after adjustment in younger individuals below or equal to 50 years old (unstandardized beta-coefficient (B) cf-PWV 0.59 m/s, p<0.001), however not in older individuals (B 0.14m/s, p = 0.32). Higher levels of AGEs were significantly associated with indirect aortic stiffness as assessed by mean Aix in both younger individuals (B 8.27, p<0.001) and older individuals (B 3.98, p<0.001). Conclusions: Our findings show that higher levels of advanced glycation end products are positively associated with increased direct and indirect arterial stiffness in younger individuals with few comorbidities, independent of cardiometabolic risk factors. Future studies are warranted to elucidate the effect of reduced AGE dietary consumption and AGE-inhibition on aortic stiffness.