Association between dietary advanced glycation end products and gallstone disease: A case-control study

Gallstone disease is a common gastrointestinal disorder involving metabolic and inflammatory pathways. Advanced glycation end products, abundant in processed foods and generated during high-temperature cooking, promote oxidative stress and inflammation, mechanisms implicated in gallstone formation. Therefore, this study investigated the association between advanced glycation end products intake and gallstone among Iranian adults.

In this case-control study, 189 newly diagnosed patients with gallstone and 342 controls were included. Dietary intake was assessed using a validated 168-item food frequency questionnaire. Dietary advanced glycation end products intake was estimated using established advanced glycation end products databases and expressed as Kilounits (Ku) per day. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for age, sex, body mass index, total energy intake, physical activity, smoking status and alcohol consumption.

Mean advanced glycation end products intake was significantly higher among gallstone cases than controls (11,027.8 ± 5903.6 vs. 9490.5 ± 4773.5 kU/day, p = 0.002). Participants in the highest quartile of advanced glycation end products had greater total energy intake and meat consumption compared with those in the lowest quartile (both p < 0.001). In the crude model, individuals in the highest quartile had twice the odds of gallstone compared with those in the lowest quartile (OR = 2.00; 95% CI = 1.20-3.34). After adjustment for potential confounders, the association remained significant (OR = 1.89; 95% CI = 1.07-3.38; p = 0.016). A significant positive trend across quartiles was observed (p for trend = 0.026).

Higher dietary advanced glycation end products were significantly associated with greater odds of gallstone. These findings suggest that reducing dietary exposure to advanced glycation end products may represent a potential nutritional strategy for gallstone prevention. Prospective studies are warranted to confirm these findings.