Advanced Glycation End Products And EsRAGE Are Associated With Bone Turnover And Incidence Of Hip Fracture In Older Men(1)

This study examined the relationship between blood sugar damage and bone health in 3,384 men aged 70-89. Researchers looked at advanced glycation end products (AGEs) - harmful compounds that form when sugar attaches to proteins in the body over time - and a protective protein called esRAGE that helps counter their effects. They also measured markers of bone formation and breakdown to understand bone health.

The findings were somewhat surprising. Higher levels of one AGE compound called CML were actually associated with a lower risk of hip fractures, contradicting what researchers expected. Meanwhile, higher levels of the protective esRAGE protein were linked to increased bone formation activity, suggesting it may help maintain healthy bone turnover. Interestingly, these blood sugar-related compounds were similar in men with and without diabetes, indicating that AGE formation occurs even in people without diabetes as they age.

The study followed the men over time and found that 106 developed hip fractures. Those with moderate levels of CML had about half the hip fracture risk compared to those with the lowest levels. This suggests that the relationship between blood sugar damage and bone health is more complex than previously thought, and that some AGEs might actually have protective effects rather than purely harmful ones.

This research is important for understanding how metabolic health affects aging and bone strength. For clinical practice, it suggests that managing blood sugar levels for bone health may be more nuanced than simply minimizing all sugar-related damage, and that measuring these specific compounds could help predict fracture risk in older adults.