Serumcarboxymethyl-lysine, an advanced glycation end product, is associatedwith arterial stiffness in older adults

Objective: The objective of this study is to examine the relationship of serum carboxymethyl-lysine (CML), an advanced glycation end product (AGE), with pulse pressure (PP), aortic pulse wave velocity (aPWV) and hypertension in older adults. Background: AGEs are bioactive molecules that accumulate in tissues with ageing and can both cross-link collagen and induce inflammation in model systems. The relationship of AGEs with arterial stiffness and hypertension has not been well characterized in community-dwelling older adults. Methods: We measured serum CML and blood pressure in 3044 adults, aged 70-79 years, who participated in the Health, Aging and Body Composition Study, a populationbased study of ageing in Pittsburgh, Pennsylvania and Memphis, Tennessee. aPWV was measured in 2468 participants. Results: Participants in the highest tertile of serum CML had higher PP (highest tertile: beta=2.85, SE=0.82, P=0.0005; middle tertile: beta=0.60, SE=0.80, P=0.45), and higher aPWV (highest tertile: beta=51.4, SE=20.1, P=0.01; middle tertile: beta=3.2, SE=19.8, P=0.87) than those in the lowest tertile in multivariable linear regression models adjusting for age, sex, race, education, BMI, smoking, alcohol use, total cholesterol, high-density lipoprotein (HDL) cholesterol, diabetes, cardiovascular disease and chronic kidney disease. Participants in the highest and middle tertiles of serum CML had higher odds of hypertension [odds ratio (OR) 1.32, 95% confidence interval (95% CI) 1.06-1.60, P=0.005; OR 1.27, 95% CI 1.05-1.53, P=0.01, respectively] than those in the lowest tertile in a multivariable logistic regression model adjusting for the same covariates. Conclusion: Elevated serum CML was associated with arterial stiffness, as reflected by higher PP and aPWV, in older, community-dwelling adults.