Association Between Advanced Glycation End Products and Sarcopenia: The Mediating Role of Osteoporosis

Context: Advanced glycation end products (AGEs) are a group of molecules formed through non-enzymatic reactions. These compounds were associated to several age-related diseases, including sarcopenia and osteoporosis.Objective: To investigate the relationships between AGEs, osteoporosis, and sarcopenia in community-dwelling older adults.Materials and methods: This cross-sectional study included 1991 older adults aged 72.37 +/- 5.90 years from China. AGE levels were measured by AGE ReaderTM device. Bone mineral density was assessed using dual-energy X-ray absorptiometry, and osteoporosis was diagnosed based on a T score < -2.5. Sarcopenia was defined as loss of muscle mass plus loss of muscle strength and/or reduced physical performance. Presarcopenia was defined as low muscle mass with normal muscle strength and normal physical performance.Results: The prevalence of sarcopenia was 18.5%, and that of osteoporosis was 40.5%. Compared to the lowest AGE quartile, the highest AGE quartile showed a significant association with sarcopenia (OR 2.42, 95% CI [1.60, 3.66]) (P for trend <0.001), but not with presarcopenia. Per standard deviation(SD) increase in AGE was associated with higher odds of sarcopenia(OR 1.44, 95% CI [1.26, 1.66]). Additionally, in the mediation analysis, when AGEs were treated as a continuous variable (the mediation effect is denoted by Za*Zb = 18.81, 95% CI [8.07, 32.32]-the 95% CI does not contain zero, representing a significant mediating effect) or a categorical variable (the mediating effect is expressed as Zmediation = 3.01 > 1.96, which represents a significant mediating effect), osteoporosis played a partial mediating role in the association between AGEs and sarcopenia.Conclusions: Elevated AGEs are associated with sarcopenia but not with presarcopenia. This association was partially mediated by osteoporosis.