Advanced glycation end products consumption and the decline of functional capacity in patients with Parkinson's disease: Cross-sectional study

Almeida, Jenifer Kristina Alves de; Brech, Guilherme Carlos; Luna, Natália Mariana Silva; Iborra, Rodrigo Tallada; Soares-Junior, Jose Maria; Baracat, Edmund Chada; Greve, Júlia Maria D'Andrea; Alonso, Angélica Castilho; Machado-Lima, Adriana

doi:10.1016/j.clinsp.2023.100320

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Original articles • Clinics 79 • 2024 • https://doi.org/10.1016/j.clinsp.2023.100320 copy

Advanced glycation end products consumption and the decline of functional capacity in patients with Parkinson's disease: Cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Highlights

Effects of AGEs in Parkinson's disease patients.
Recommendation healthy diet with a low AGE consumption.
Parkinson's disease patients’ lower strength and worsened functional capacity.

Abstract

Introduction

Advanced Glycation End-Products (AGEs) are a diverse group of highly reactive molecules that play a vital role in the development of neurodegenerative disorders, such as Parkinson's Disease (PD), leading to a decline in functional and cognitive capacity. The objective of this study was to assess the intake and quantification of AGEs in individuals with PD and to correlate them with their functional and cognitive abilities.

Methods

This was a cross-sectional study involving 20 PD patients and 20 non-PD individuals as the Control group (C). The autofluorescence reader was used to evaluate skin AGEs, while food recall was used to quantify AGEs consumed for three different days. The Montreal Cognitive Assessment, Short Physical Performance Battery, and handgrip tests were used. PD patients demonstrated greater impairment in functional capacity compared to the control group.

Results

Dominant Handgrip (p = 0.02) and motor performance, in the sit and stand test (p = 0.01) and Short Physical Performance Battery (SPPB) (p = 0.01) were inferior in PD patients than the control group. Although PD patients tended to consume less AGEs than the control group, AGE intake was negatively correlated with handgrip strength in individuals with PD (r = -0.59; p < 0.05).

Conclusion

PD patients had lower strength and functional capacity, suggesting that the effects of AGEs might be exacerbated during chronic diseases like Parkinson's.

Keywords
Advanced glycation end-products; Parkinson's disease; Aging; Functional capacity

	PD (n = 20)	Control (n = 20)	t	p	95% CI
General data
Age (years)	70 ± 10.3	69 ± 6.1	0.66	0.52	-7.16; 3.65
Associated comorbidities	0.9 ± 1.0	0.8 ± 0.7	0.73	0.35	-0.67; 0.47
Family income (US Dolar)	1512 ± 773	1460 ± 843	0.21	0.84	-571; 464
Medicines for continuous use	3.7 ± 2.4	1.9 ± 1.7	2.58	0.01^a a Level of significance adopted (p < 0.05).	-3036; -0.36
UPDRS	9.15 ± 5.8	‒
Anthropometry
BMI (kg/m²)	26.4 ± 2.9	27.1 ± 3.7	1.23	0.23	-3.41; 0.83
AC (cm)	98.8 ± 10.2	91.1 ± 10.8	2.31	0.03	-14.40; -0.95
Cognitive ability
MoCA	22.5 ± 4.2	24.8 ± 3.1	1.63	0.11	-0.47; 4.27
Functional capacity
Handgrip test DS (Kg/f)	18.8 ± 6.9	27. 1 ± 12.9	2.52	0.02^a a Level of significance adopted (p < 0.05).	1.64; 14.90
Handgrip test NDS (Kg/f)	19.4 ± 9.4	24.3 ± 10.5	1.54	0.13	-1.53; 11.21
Gait speed (m/s)	7.2 ± 4.8	6.1 ± 2.1	0.96	0.34	-3.51; 1.25
Sit to Stand test (s)	15.1 ± 3.0	11.7 ± 3.7	3.19	0.01^a a Level of significance adopted (p < 0.05).	-5.55; -1.24
SPPB	8.5 ± 2.2	10 ± 1.5	2582	0.01^a a Level of significance adopted (p < 0.05).	0.34; 2.76
AGE Formation
AF (AU)	2.64 ± 0.61	3.06 ± 0.52	2.18	0.04	0.03; 0.80
Rec 24hrs (kU/d)	17028 ± 11392	24561 ± 15187	1.78	0.08	-1060; 16127
Rec 48hrs (kU/d)	18182 ± 11439	24981 ± 13077	1.75	0.09	-1066; 14664
Rec habitual (kU/d)	19722 ± 8072	24091 ± 15046	1.14	0.26	-3361; 3818
Average Consumption (kU/d)	18311 ± 6458	24544 ± 13384	1.88	0.07	-494; 12961
AGE consumption from food (kU/d)
Grilled (days of the week)	1.450 ± 1.91	2.50 ± 19.33	2.07	0.05	0.02; 2.08
Frying (days of the week)	2.0 ± 1.92	0.65 ± 0.88	2.86	0.01^a a Level of significance adopted (p < 0.05).	-2.31; -0.40
Roast (days of the week)	1.60 ± 1.10	1.05 ± 0.99	1.66	0.11	-1.22; 0.12
Cooked (days of the week)	4.25 ± 2.29	5.00 ± 1.97	1.11	0.27	-0.62; 2.12

Control group	Model 1		Model 2		Model 3		Model 4
Variables	β	EP	β	EP	β	EP	β	EP
General data
Age (years)	-0.10	0.08	-0.11	0.08	-0.12	0.09	-0.12	0.11
Comorbidities	-0.23	0.31	-0.12	0.33	-0.10	0.34	-0.17	0.36
Medicines	-0.10	0.08	-0.11	0.08	-0.12	0.09	-0.12	0.11
AGE
AGE consumption (kU/d)			0.01	0.01	0.01	0.01	0.01	0.01
AF (AU)			0.93	0.88	0.97	0.92	0.73	0.10
Anthropometry
BMI (kg/m²)					-0.10	0.42	-0.25	0.47
AC (cm)					0.01	0.12	0.06	0.13
Motor Domain
Hand grip test NDS (kg/f)							-0.11	0.15
Hand grip test DS (kg/f)							0.02	0.14
Gait speed (m/s)							0.04	0.21
Sit to stand (s)							-0.15	0.23
R squared	0.08		0.12		0.12		0.17
Parkinson disease group
General data
Age (years)	-0.12	0.11	-0.12	0.12	-0.09	0.13	0.22	0.22
Disease duration (years)	-0.07	0.34	-0.11	0.37	-0.14	0.36	0.45	0.45
Comorbidities	0.22	1.17	0.18	1.31	0.25	1.4	2.76	2.76
Medicines	0.23	0.51	0.09	0.65	-0.07	0.65	0.79	0.79
AGE
AGE consumption (kU/d)			0.01	0.01	0.01	0.01	0.01	0.01
AF (AU)			1.12	1.68	1.13	1.68	2.57	2.57
Anthropometry
BMI (kg/m²)					0.25	0.69	1.30	1.30
AC (cm)					0.12	0.18	0.30	0.30
Motor Domain
Hand grip test NDS (kg/f)							0.35	0.35
Hand grip test DS (kg/f)							0.55	0.55
Gait speed (m/s)							0.35	0.52
Sit to stand (s)							0.45	0.89
R squared	0.07		0.11		0.28		0.40

Group control	Model 1		Model 2		Model 3		Model 4
Variables	β	EP	β	EP	β	EP	β	EP
General data
Age (years)	-0.02	0.07	-0.04	0.07	-0.07	0.07	-0.07	0.09
Comorbidities	-0.28	0.23	-0.16	0.25	0.00	0.29	-0.02	0.31
Medicines	-0.02	0.07	-0.04	0.07	-0.07	0.07	-0.07	0.09
AGE
AGE consumption (kU/d)			0.01	0.01	0.01	0.01	0.01	0.01
AF (AU)			-0.29	0.55	0.09	0.57	0.10	0.60
Anthropometry
BMI (kg/m²)					0.19	0.35	0.11	0.39
AC (cm)					-0.12	0.10	-0.11	0.11
Total Muscle Mass (kg)					-0.36	0.51	-0.06	0.65
Motor Domain
Hand grip test NDS (kg/f)							0.10	0.10
Hand grip test DS (kg/f)							-0.06	0.08
r square	0.12		0.23		0.47		0.53
Parkinson disease group
General data
Age (years)	-0.13	0.05	-0.13	0.05	-0.184	0.051	-0.17	0.06
Disease duration (years)	-0.14	0.15	-0.09	0.15	-0.062	0.140	-0.06	0.15
Comorbidities	-0.20	0.53	-0.12	0.54	-0.616	0.538	-0.59	0.59
Medicines	0.16	0.23	0.28	0.27	0.321	0.253	0.33	0.28
AGE
AGE consumption (kU/d)			0.01	0.01	0.01	0.01	0.01	0.01
AF (AU)			-1.22	0.70	-1.66	0.66	-1.60	0.78
Anthropometry
BMI (kg/m²)					-0.41	0.28	-0.41	0.32
AC (cm)					0.15	0.07	0.14	0.08
Total Muscle Mass (kg)					-0.52	0.41	-0.36	0.53
Motor Domain
Hand grip test NDS (kg/f)							0.08	0.14
Hand grip test DS (kg/f)							-0.09	0.20
R squared	0.33		0.47		0.67		0.68

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[1] ⁎ Corresponding author at: Graduate Program in Aging Sciences, Universidade São Judas Tadeu (USJT), São Paulo, SP, Brazil. E-mail address:guibrech@gmail.com (G.C. Brech).