Abstract
Introduction: It has been proposed that advanced glycation end-products (AGEs) are contributory factors in diabetic nephropathy (DN) pathogenesis. Interventions regarding restriction dietary AGEs (dAGEs) intake indicate improvement in clinical outcomes.
Objectives: The present study aimed to compare the effects of 10-week low AGEs diet (LAGEsd) based on recommended diabetic diet (DD) versus DD alone on glycemic status, lipid profile, serum creatinine (sCr), blood urea nitrogen (BUN), urine albumin to creatinine ratio, eGFR and urine albumin in patients with DN.
Patients and Methods: This randomized, double-blind clinical trial was conducted on 62 patients with DN. Patients were assigned randomly to LAGEsd (n=31) and DD (n=31) groups for 10 weeks. All patients were prescribed calorie adjusted diet in regards to American Diabetes Association’s recommendation. In addition, patients in the LAGEsd group were instructed how to reduce dAGEs intake based on established guidelines. Demographic data were collected and dietary intakes, physical activity level, fasting blood sugar (FBS), hemoglobin A1C (HbA1c), lipid profile, sCr, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urine albumin to creatinine ratio (Alb/Cr), and urine albumin were measured before and after of 10-weeks intervention, and compared between the two groups.
Results: The results showed that dAGEs intake decreased significantly in the LAGEsd group compared with the DD group (P<0.001). In the LAGEsd group, eGFR improved significantly compared with the DD group (18.77±20.99 mL/min/1.73 m2 versus 1.57±21.06 mL/min/1.73 m2 , P=0.002); however there were no significant difference in FBS, HbA1c, lipid profile, sCr, BUN, urine Alb/Cr, and urine albumin between the two groups (P>0.05).
Conclusion: In sum, dAGEs restriction plus DD is superior to DD alone in improvement of renal function marker in patients with DD.
Trial Registration: This study was registered at Iranian Registry of Clinical Trials (identifier: IRCT20191004044979N1, https://en.irct.ir/trial/42914, ethical code #IR.SUMS.REC.1398.798).