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Advanced glycation end products and the CALLY index reflect inflammatory burden in familial Mediterranean fever

Altuğ Güner1, Sümeyye Tuna Güner2

  • 1Department of Rheumatology, Bursa City Hospital, Bursa, Turkey. guner_88_8@hotmail.com.

Scientific Reports
|June 20, 2026
PubMed

Insights

Advanced glycation end products (AGEs) accumulate in Familial Mediterranean Fever (FMF), a chronic inflammatory condition. Higher AGE accumulation in FMF patients inversely correlated with the CALLY index, a marker of inflammation and nutrition.

Area of Science:

  • Rheumatology
  • Immunology
  • Metabolic Medicine

Background:

  • Familial Mediterranean Fever (FMF) is a primary autoinflammatory disorder marked by recurring inflammation.
  • Advanced glycation end products (AGEs) are associated with chronic inflammation, oxidative stress, and complications like cardiovascular disease.
  • The C-reactive protein-albumin-lymphocyte (CALLY) index is a composite biomarker for inflammatory and nutritional status, but its link to AGEs in FMF is unknown.

Purpose of the Study:

  • To assess tissue AGE accumulation using skin autofluorescence (AGE-SAF) in FMF patients.
  • To explore the relationship between AGE-SAF and the CALLY index.
  • To investigate associations between AGE-SAF and inflammatory, metabolic, and clinical factors in FMF.

Main Methods:

  • A cross-sectional study involving 87 FMF patients and 52 healthy controls.
  • Non-invasive measurement of skin autofluorescence (AGE-SAF) using an AGE Reader™ device.
  • Calculation of the CALLY index using C-reactive protein (CRP), albumin, and lymphocyte counts; statistical analysis included non-parametric tests and Spearman's correlation.

Main Results:

  • FMF patients exhibited significantly higher AGE-SAF levels compared to healthy controls (2.06 ± 0.44 vs. 1.70 ± 0.20 AU; p < 0.001).
  • Elevated AGE-SAF in FMF patients correlated with inflammatory markers (e.g., CRP) and metabolic parameters.
  • A significant inverse association was observed between AGE-SAF and the CALLY index in FMF patients.

Conclusions:

  • Tissue AGE accumulation is increased in patients with FMF.
  • AGE-SAF is linked to inflammatory and metabolic dysregulation in FMF.
  • The CALLY index may not fully capture the burden of AGE accumulation in FMF, as indicated by the inverse correlation.
Keywords:
Advanced glycation end productsCALLY indexChronic inflammationFamilial Mediterranean feverMetabolic burdenSkin autofluorescence

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