SAT-577 Assessing Advanced Glycation End-products (AGEs) in Type 1 Diabetes: Contributions of Serum, Dietary, and Skin AGEs

Abstract Disclosure: C.E. Nevarez: None. R.Z. DeCurtis: None. P. Sanchez-Orive: None. B.E. Gray: None. A.B. Murthy: None. M. Bouxsein: None. Introduction: Advanced glycation end-products (AGEs) such as carboxymethyl-lysine (CML) contribute to the development of diabetic complications. We previously reported that dietary AGE intake and skin AGEs were higher among adults with longstanding Type 1 Diabetes (T1D) as compared to nondiabetic controls and correlated with hemoglobin A1c. We now seek to evaluate how serum AGEs are associated with dAGE and skin AGEs as well as diabetic outcomes. Methods: The T1D BEACON cohort includes adults aged 50+ years with and without T1D (n=97 T1D, n=57 non-diabetic controls). Fasting morning serum CML levels were measured using the Human Carboxymethyl-Lysine ELISA Kit (Competitive EIA; LSBio, LifeSpan BioSciences, Inc.).We also quantified dietary AGE intake (dAGE) using a novel algorithm we previously reported, and obtained autofluorescent skin AGEs (AGE Reader, DiagnOptics Technologies) as well as assessments of diabetic microvascular disease (MVD, e.g. nephropathy, retinopathy, or neuropathy), hemoglobin A1C, 10-year A1C history, and 14-day continuous glucose monitoring (CGM). We compared serum CML between T1D and controls and evaluated associations with dAGEs, skin AGEs, and diabetic outcomes using independent t-tests, Pearson’s correlations, and multivariate linear regression with adjustments for age, sex, and body mass index (BMI). Results: The T1D and control groups had similar baseline characteristics (mean age 63.8 ± 6.8 years, 49.4% female, 76% with MVD). In the T1D group, average A1C was 7.1 ± 1.0%, 10-year A1c 7.6± 0.9%, and CGM time in target range 63%. Serum CML was similar in T1D and controls (1048 ± 890 vs 886 ± 572, adjusted p=0.396) and did not significantly correlate with dAGE intake, skin AGE levels, A1c, 10-year A1c history, nor CGM time in target range in unadjusted or adjusted analyses. Within the T1D group, skin AGEs were higher among those with MVD as compared to those without MVD (3.10 ± 0.69 vs 2.77 ± 0.43, adjusted p=0.012), although dAGEs and serum AGEs did not differ between these groups. Conclusion: Serum CML was not correlated with dAGE intake or skin AGEs and did not distinguish between adults with and without T1D. These findings diverge from our prior observations that dAGEs and skin AGEs are elevated in T1D and are correlated with each other and glycemic outcomes, highlighting the complexity of AGE biology in diabetes. Our data suggest that dAGEs and skin AGEs may serve as more reliable markers than serum CML for assessing diabetic outcomes. Presentation: Saturday, July 12, 2025