Dietary Advanced Glycation End-Products (AGEs) and Mortality After Breast Cancer in the Women's Health Initiative (WHI)
Menée aux Etats-Unis à partir de données portant sur 2 023 patientes atteintes d'un cancer invasif du sein et âgées de 50 à 79 ans, cette étude analyse l'association entre une consommation de produits finaux de glycation avancée et la mortalité (durée médiane de suivi : 15,1 ans ; 630 décès)
Background: Advanced glycation end-products (AGEs) are formed through nonenzymatic glycation of free amino groups in proteins or lipid. They are associated with inflammation and oxidative stress and their accumulation in the body is implicated in chronic disease morbidity and mortality. We examined the association between post-diagnosis dietary N
Ɛ-carboxymethyl-lysine (CML)-AGE intake and mortality among women diagnosed with breast cancer (BC). Methods: Postmenopausal women aged 50 to 79 years were enrolled in the Women's Health Initiative between 1993 and 1998 and followed up until death or censoring through March 2018. We included 2,023 women diagnosed with first primary invasive BC during follow-up who completed a food frequency questionnaire (FFQ) after diagnosis. Cox proportional hazards (PH) regression models estimated adjusted hazard ratios (HR) and 95% confidence intervals (CIs) of association between tertiles of post-diagnosis CML-AGE intake and mortality risk from all-causes, BC, and cardiovascular disease (CVD). Results: After a median 15.1 years of follow-up, 630 deaths from all-causes were reported (193 were BC-related and 129 were CVD-related). Post-diagnosis CML-AGE intake was associated with all-cause (HRT3vsT1: 1.37, 95% CI: 1.09-1.74), BC (HRT3vsT1: 1.49, 95% CI: 0.98-2.24) and CVD (HRT3vsT1: 1.91, 95% CI: 1.09-3.32) mortality. Conclusions: Higher intake of AGEs was associated with higher risk of major causes of mortality among postmenopausal women diagnosed with BC. Impact: Our findings suggest that dietary AGEs may contribute to the risk of mortality after BC diagnosis. Further prospective studies examining dietary AGEs in BC outcomes and intervention studies targeting dietary AGE reduction are needed to confirm our findings.