Dietary advanced glycation end products may increase the incidence of allergic rhinitis depending on genetic susceptibility: a prospective cohort study†
Abstract
Background: Limited evidence exists for the relationship between dietary advanced glycation end product (AGE) intake and allergic rhinitis (AR). Herein, the association between dietary AGEs and the risk of developing AR and whether genetic susceptibility influences the effects of dietary AGEs on AR were explored. Methods: In total, 125 276 participants without AR at baseline and having completed at least two 24-hour dietary recalls from the UK Biobank (2006–2010) were included. Dietary AGEs, specifically Nε-(1-carboxyethyl)-L-lysine (CEL), Nε-(carboxymethyl) lysine (CML), and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl) ornithine (MG-H1), were quantified by coupling 24-hour food assessments with a validated dietary AGE database. The incidence of allergic rhinitis was determined through hospital admissions. Multivariate Cox regression models were used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) of the association between dietary AGE intake and the risk of AR. Results: During a median follow-up period of 12.4 years, 1171 individuals developed AR. In the fully adjusted model, higher dietary AGEs (HR: 1.27; 95% CI: 1.07, 1.50; P-trend = 0.006) and MG-H1 intake (HR: 1.19; 95% CI: 1.01, 1.41; P-trend = 0.046), especially the dietary AGEs derived from baked foods (HR: 1.23; 95% CI: 1.03, 1.46; P-trend = 0.020) and from nuts and legumes (HR: 1.24; 95% CI: 1.05, 1.47; P-trend = 0.013) were associated with an increased risk of AR. Among participants with a low genetic risk of AR, the HRs (95% CI) of AR were 1.32 (1.01, 1.73) and 1.37 (1.05, 1.79) for dietary AGE and MG-H1 intake, respectively. Conclusions: Dietary AGE intake was associated with an increased risk of AR, which was modified through genetic predisposition.