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Systematic Review

Advanced Glycation End-Products in Common Non-Infectious Liver Diseases: Systematic Review and Meta-Analysis

1
Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wrocław, Poland
2
Department of Gastroenterology and Hepatology, Wroclaw Medical University, 50-556 Wrocław, Poland
3
Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland
*
Author to whom correspondence should be addressed.
Academic Editor: Antonio Colecchia
Received: 24 August 2021 / Revised: 19 September 2021 / Accepted: 20 September 2021 / Published: 25 September 2021
Background: Excessive intake of fructose, glucose and alcohol is associated with the development of non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). At the same time, these dietetic factors create an environment favorable for the generation of advanced glycation end-products. For this reason, advanced glycation end-products (AGEs) are hypothesized to play role in the development of NAFLD and ALD. In this systematic review and meta-analysis, we explore the relationship between NAFLD and ALD with AGE levels, including their diagnostic accuracy. Methods: The systematic review and meta-analysis has been pre-registered with PROSPERO (CRD42021240954) and was performed in accordance with the PRISMA guidelines. Meta-analyses were performed using the meta R package. Results: We have obtained 11 studies meeting our inclusion criteria, reporting data on 1844 participants (909 with NAFLD, 169 with ALD and 766 healthy controls). NAFLD was associated with significantly higher AGE fluorescence and serum N-(carboxyethyl)lysine (CEL) levels. Patients with alcoholic cirrhosis had significantly higher levels of N-(carboxymethyl)lysine (CML). Only individual studies examined AGEs in the context of their diagnostic accuracy. AGE fluorescence distinguished low and moderate steatosis with an AUC of 0.76. The ratio of CML, CEL and pentosidine to a soluble variant of the AGE receptor differentiated patients with NAFLD from healthy controls with high AUC (0.83–0.85). Glyceraldehyde-derived AGE separated non-alcoholic fatty liver (NAFL) from non-alcoholic steatohepatitis (NASH) with acceptable performance (AUC 0.78). Conclusions: In conclusion, NAFLD and ALD are associated with significantly higher levels of several AGEs. More research is needed to examine the diagnostic accuracy of AGEs, however individual studies show that AGEs perform well in distinguishing NAFL from NASH. View Full-Text
Keywords: serum levels of AGE; advanced glycation end-products; liver disease; alcohol; fructose serum levels of AGE; advanced glycation end-products; liver disease; alcohol; fructose
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MDPI and ACS Style

Litwinowicz, K.; Waszczuk, E.; Gamian, A. Advanced Glycation End-Products in Common Non-Infectious Liver Diseases: Systematic Review and Meta-Analysis. Nutrients 2021, 13, 3370. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103370

AMA Style

Litwinowicz K, Waszczuk E, Gamian A. Advanced Glycation End-Products in Common Non-Infectious Liver Diseases: Systematic Review and Meta-Analysis. Nutrients. 2021; 13(10):3370. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103370

Chicago/Turabian Style

Litwinowicz, Kamil, Ewa Waszczuk, and Andrzej Gamian. 2021. "Advanced Glycation End-Products in Common Non-Infectious Liver Diseases: Systematic Review and Meta-Analysis" Nutrients 13, no. 10: 3370. https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103370

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