Association Between Advanced Glycation End-Products and Adherence to the Mediterranean Diet in Individuals with Type...

Background/Objectives: Advanced glycation end-products (AGEs) are implicated in the vascular complications of type 2 diabetes mellitus (T2DM). Although the Mediterranean diet (MD) confers well-recognized benefits, adherence among people with T2DM is moderate. Evidence regarding the relationship between adherence to the MD and AGEs remains limited. This study aimed to investigate the association between adherence to the MD and AGE levels in individuals with T2DM in Greece. Methods: Adults with T2DM were enrolled in this cross-sectional study. Ocular and skin AGEs were assessed using autofluorescence techniques, while serum AGEs were quantified using an enzyme-linked immunosorbent assay (ELISA). MD adherence was scored with the Mediterranean Diet Score (MedDietScore) (range 0-55). Results: Sixty-one individuals were studied (mean age: 65 ± 9 years; 35 men). Median glycated hemoglobin (HbA1c) and MedDietScore were 6.95 (6.2-7.5)% and 29.0 (27.5-31.5), respectively. Higher adherence to the MD was more frequent among women (p = 0.019) and was associated with lower HbA1c levels (p = 0.002). MedDietScore was inversely correlated with HbA1c (ρ = -0.437, p < 0.001), ocular AGEs (ρ = -0.435, p = 0.013), and skin AGEs (ρ = -0.309, p = 0.033). In multivariable regression analyses, higher adherence to the MD was independently associated with lower ocular (p = 0.043) and skin AGEs (p = 0.005). Conclusions: Higher adherence to the MD was associated with female sex and lower HbA1c. MedDietScore was inversely related to skin, and ocular AGE levels in individuals with T2DM.