Dietary advanced glycation end products and risk of cardiometabolic disorders in older adults: cross-sectional data from the 2007–2021 Korea National Health and Nutrition Examination Survey (KNHANES)

Advanced glycation end products (AGEs) have been identified as potential dietary risk factors for cardiometabolic disorders. Despite studies in Western populations, little is known about the impact of AGEs in elderly Asian with different dietary patterns and aging dynamics. This study aimed to examine the association between dietary intake of three representative AGEs—Nɛ-(carboxymethyl)lysine (CML), Nɛ-(1-carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl)-ornithine (MGH1)—and the risk of cardiometabolic disorders among older Korean adults. A total of 6,731 individuals aged 65 years and older participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from which cross-sectional data collected between 2007 and 2021 were analyzed. Dietary AGEs intake was estimated using a food-based AGEs composition database linked to 24-hour dietary recall data. Participants were categorized into quartiles according to energy-adjusted AGEs intake. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the associations between dietary AGEs intake and cardiometabolic disorders including hypertension, type 2 diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia. Higher dietary intake of CML and MGH1 was significantly associated with increased odds of type 2 diabetes (OR, 95% CI, CML = 1.33, 1.12–1.58, P for trend < 0.001; MGH1 = 1.25, 1.05–1.49, P for trend = 0.007) and hypercholesterolemia (OR, 95% CI, CML = 1.61, 1.34–1.92, P for trend < 0.001; MGH1 = 1.24, 1.03–1.48, P for trend = 0.032). CEL intake was independently associated with hypercholesterolemia (OR, 95% CI = 1.54, 1.29–1.84, P for trend < 0.001). In contrast, no significant associations were observed between AGEs intake and hypertension or hypertriglyceridemia. Although absolute differences in continuous biomarkers such as fasting glucose and total cholesterol across AGEs quartiles were small, consistent dose–response trends were observed, suggesting cumulative metabolic alterations associated with higher dietary AGEs intake. High intake of dietary AGEs, particularly CML and MGH1, may contribute to increased risk of type 2 diabetes and hypercholesterolemia in older Korean adults. Given the cross-sectional design of this study, causal inferences cannot be drawn; however, these findings suggest that considering AGEs may be relevant for dietary strategies and cardiometabolic health in aging societies.