Skin Advanced Glycation End Products (AGEs) are not associated with bone mineral density longitudinally: The Rotterdam Study.

Abstract

Background: Advanced glycation end products (AGEs), formed through non-enzymatic glycation of, e.g., proteins in collagen have been associated with prevalent fractures, but their relation with bone mineral density (BMD) and trabecular bone score (TBS) is unclear.

Objectives: To assess the association of skin AGEs with BMD and TBS changes over time.

Methods: In the Rotterdam Study, skin AGEs were assessed as skin autofluorescence (SAF) using the AGE Reader®. Total body (TB), femoral neck (FN) and lumbar spine (LS) BMD were assessed using dual-energy X-ray absorptiometry (DXA). SAF was analyzed with baseline and follow-up BMD and TBS, employing a linear mixed effects model adjusted for clinical and lifestyle confounders, with interaction analysis for sex, prevalent type 2 diabetes mellitus (T2DM), chronic kidney disease, and bisphosphonate use.

Results: Longitudinal analyses between SAF and TB BMD were performed in 2553 participants (mean follow-up time 4.9 years), and between SAF and LS BMD, FN BMD and TBS in 851 participants (mean follow-up 5.6 years). SAF was not associated with BMD nor with TBS changes over time. Significant interactions were observed with sex (TB and FN BMD) and with diabetes (FN BMD), but stratified analysis revealed no significant associations.

Conclusion: We did not observe a longitudinal association between SAF and BMD at multiple sites or TBS, which is consistent with our earlier findings that associations of SAF with prevalent fractures were not explained by BMD or TBS. Other aspects of bone quality or muscle characteristics including fall risk may be involved.