Dietary and Plasma Carboxymethyl Lysine and Tumor Necrosis Factor-α as Mediators of Body Mass Index and Waist Circumference among Women in Indonesia

Abstract

Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19–50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7–3.0) mg/day, 22.2 (17.2–28.2) ng/mL and 0.68 (0.52–1.00) IU/mL, respectively, and significantly higher in the WC ≥ 80 cm than in the WC < 80 cm group, but not in BMI ≥ 25 kg/m2 compared to BMI < 25 kg/m2 group. Plasma CML and pTNF-α were positively and directly related to WC (β = 0.21 [95% CI: 0.09, 0.33] and β = 0.23 [95% CI: 0.11, 0.35], respectively). Dietary CML that correlated with dry-heat processing and cereals as the highest contributions was positively related to WC (β = 0.33 [95% CI: 0.12, 0.83]). Ethnicity, level of education, intake of fat, and intake of energy contributed to dCML, pCML and pTNF-α, and subsequently affected WC, while only ethnicity contributed to BMI through dCML, pCML and pTNF-α (β = 0.07 [95% CI: 0.01, 0.14]). A positive direct effect of dCML on pCML and of pCML and pTNF-α on WC was seen among Indonesian women. Dietary CML seems to have several paths that indirectly influence the increases in WC if compared to BMI. Thus, intake of CML-rich foods should be reduced, or the foods consumed in moderate amounts to avoid the risk of central obesity in this population.

Pentosidine and carboxymethyl-lysine associate differently with prevalent osteoporotic vertebral fracture and various bone markers

“…In contrast, our findings showed a significant positive correlation between serum CML level and hip fat mass as well as the prevalence rate of DM. Liman et al very recently reported in an Indonesian cohort that CML levels might be associated with obesity, which was in agreement with our findings, and advised a reduction in CML-rich foods to reduce obesity risk 36 . The discrepancy between Semba's data and our own might be attributable to differences in patient ethnicity (Caucasian vs. Japanese or Asian) or the composition of co-morbidities, especially DM.…”

“…There have been contradictory reports on the association of circulating CML levels with the risk of Barzilay et al identified an association between increasing CML levels and hip fracture risk that was independent of hip BMD 16 , whereas Lamb et al showed that men with lower quartiles of plasma CML had a higher incidence of hip fracture 17 . On the other hand, there have been no reports on the relationship between CML and vertebral fracture, with conflicting results also existing on the association between circulating CML levels and obesity 35,36 . The present study revealed significantly higher serum CML levels in patients with DM or prevalent vertebral fracture.…”

Advanced Glycation End Products (AGEs): Biochemistry, Signaling, Analytical Methods, and Epigenetic Effects

“…These compounds are of importance in vivo and can be used to monitor the level of AGE accumulation during pathological conditions such as diabetes. CML represents the most prevalent AGE in vivo [52,53], and it is frequently used as the AGE marker [54]. It can be formed through various pathways, including condensation of glucose with lysine of the amino group and successively rearrangement of the Amadori product, which undergoes oxidation and forms CML.…”

Evaluasi Pengukuran Glukosa Darah Puasa dan Asam Urat pada Lanjut Usia di Kelurahan Angke, Jakarta Barat

“…(Harbuwono et al, 2018) Di sisi lain terdapat penelitian yang dilakukan pada perempuan dengan suku dari Sumatra Barat dan Jawa Barat, berusia 19-50 tahun dengan tidak memiliki penyakit diabetes mellitus memperlihatkan hasil bahwa indeks massa tubuh tidak berhubungan dengan tingkat pendidikan, konsumsi makanan tinggi lemak, konsumsi makanan tinggi energi, dan aktivitas fisik. Namun pada studi ini menemukan lingkar pinggang memiliki korelasi terhadap tingkat pendidikan, konsumsi makanan tinggi lemak, konsumsi makanan tinggi energi, dan aktivitas fisik (Liman et al, 2019).…”