Dietary advanced glycation end-products and risks of lung cancer and chronic respiratory diseases

Background: Advanced glycation end-products (AGEs) can promote inflammation and oxidative stress, and are involved in the onset of various chronic diseases. Diet has been identified as a major source of exogenous AGEs. However, epidemiological evidence regarding the role of dietary AGEs in respiratory-related diseases remains scarce. Methods: We included 153,897 participants from the UK Biobank, for whom food consumption information was collected via 24-hour dietary questionnaires. We estimated the daily intakes of total AGEs comprising N ε -(carboxymethyl)-lysine (CML), N ε -(1-carboxyethyl)-lysine (CEL), and N delta -(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1), and categorized them into 17 food groups. Multivariable Cox proportional hazards models were used to estimate the hazards ratios (HRs) and 95% confidence intervals (CIs) of total and different food-derived AGEs with lung cancer and chronic respiratory diseases. Results: After a median follow-up of 10.57 and 10.81 years, 1,073 cases of lung cancer and 19,584 cases of chronic respiratory disease were ascertained, respectively. Higher intakes of total AGEs, CML, CEL, and MG-H1 were associated with lower risks of lung cancer (mainly lung adenocarcinoma, HRs Q5 vs. Q1 : 0.60-0.72) and chronic respiratory diseases (asthma, COPD, IPF, and pneumonia, HRs Q5 vs. Q1 : 0.67-0.91). Additionally, meats-derived AGEs were related to an increased lung cancer risk (HR Q5 vs. Q1 =1.26, 95% CI: 1.04-1.53), whereas a reduced risk of lung cancer was associated with AGEs from nuts (HR Q5 vs. Q1 =0.69, 95% CI: 0.59-0.81). Beverages-, meats-, potatoes-, and sweets-derived AGEs increased the risk of chronic respiratory diseases by 4%~10% ( P trend <0.05), while increased intakes of AGEs from cereals, vegetables and fruits, nuts and most other foods presented a protective trend against chronic respiratory diseases ( P trend <0.05). Conclusions: There existed an inverse association of dietary AGEs exposure with lung cancer and chronic respiratory diseases. The different role of AGEs by diverse food sources needs to be emphasized when assessing their impacts on health outcomes.