Characterizing Dietary Advanced Glycation End-Product (dAGE) Exposure and Colorectal Adenoma Recurrence: A Secondary Analysis

Abstract

Purpose: Colorectal cancer (CRC) is the third most common cancer diagnosed among men andwomen in the United States. Adenomatous polyps are the most common type of polyps that can develop into CRC. Studies have suggested that red meat and processed meat consumption is strongly associated with risk for adenomas and CRC. Advanced Glycation End products (AGEs) are organic molecules that form endogenously or in the process of cooking of meat products in dry and/or high heat. AGEs have been speculated to drive CRC and serve as a modifiable dietary exposure. Few studies have evaluated the association between dietary AGE intake and cancer risk and no studies have addressed adenoma risk or recurrence. The objective of this study was to determine the association, if any, between dietary AGEs and adenoma recurrence. Methods: A secondary data analysis was conducted using an existing dataset from a pooled sample of participants in the Wheat Bran Fiber trial (WBF) and Ursodeoxycholic Acid (UDCA) adenoma prevention trials. Primary outcomes in both trials include adjudicated adenoma status post intervention period (average 3.1 years ). Participants completed a baseline Arizona Food Frequency Questionnaire (AFFQ) to estimate AGE exposure. N€- carboxymethyl-lysin (CML)- AGE values were assigned and quantified for foods in the AFFQ using a published AGE database, and participants exposure was evaluated as quartiles of CML-AGE (ku/1000 kcal) intake. A series of regression models were run to determine the relationship between CML-AGE intake and adenoma recurrence in participants. Results: The sample included 1976 adults (31.9% female); with mean age of 67.2 y ± 7.34. The average CML-AGE intake was 5251.1 ± 1633.1 (kU/1000kcal), ranging between 4960 – 17032.4 (kU/1000kcal). Higher intake of CML-AGE had no significant association with odds of adenoma recurrence [OR(95% CI) = 1.02 (0.71,1.48)] compared to participants with lower intake. Conclusion: In this sample of adults, CML-AGE intake was not associated with adenoma recurrence. Future research is needed to confirm these findings. Studies should expand to examine intake of different types of dAGEs with consideration of direct measurement of AGE.