The relationship between advanced glycation end products, metabolic metrics, HbA1c, and diabetic nephropathy

Background: In this cross-sectional study, we aim to investigate the value of non-invasive advanced glycation end products (AGEs) detection in the early screening of diabetic nephropathy(DN) among individuals with type 2 diabetes mellitus and assess whether metabolic parameters and glycated hemoglobin A(1c) (HbA(1c)) can moderate this relationship. Methods: A total of 912 T2DM patients were enrolled. The urinary albumin-to-creatinine ratio (UACR) was measured in morning urine samples to assess DN. AGEs were non-invasively measured through skin autofluorescence. Recognizing the role of age in both AGEs and DN, AGE(age) was calculated as AGEs x age/100 for related analyses. Results: The overall prevalence of DN in the present study was 37.2%. Elevated AGE(age)(chi(2) = 61.06) was associated with a higher prevalence of DN. Multivariable linear regression demonstrated that AGE(age) was positively associated with UACR levels(beta = 0.154, 95% CI: 0.126, 0.306, P<0.001). In the moderation analysis, glycated hemoglobin A(1c) (HbA(1c)) affected the correlation between AGE(age) and UACR. Body mass index (BMI) and triglyceride glucose-body mass index (TyG-BMI) also affect the correlation between AGE(age) and UACR, there were significant interactions between AGE(age), HbA(1c), BMI, TyG-BMI, and UACR. Conclusions: Complex associations and interactions were observed between AGEs, metabolic metrics, HbA(1c), and DN. Implementing comprehensive interventions can potentially benefit the prevention of DN in T2DM patients.