High parenteral carbohydrate intakes in patients with chronic intestinal failure are associated with accumulation of advanced glycation end products.

Advanced glycation end-products (AGE) are the product of non-enzymatic reactions between reduced carbohydrates, peptides, lipids, nucleic acids. AGE accumulate over time, they are considered as the metabolic memory. In certain pathologies such as diabetes mellitus, AGE accumulation is increased and correlated with vascular complications. Patients with chronic intestinal failure dependent on parenteral nutritional have long-term intravenous carbohydrate intakes. The assessment of AGE levels in this population has never been performed. We measured skin AGE levels by auto-fluorescence in 23 adults followed in a tertiary center for chronic intestinal insufficiency and treated with home parenteral nutrition that we compared to the values of the general population. We also analyzed factors associated with elevated AGE. More than half (n=13) had elevated AGE. The presence of elevated AGE was significantly associated with higher parenteral carbohydrate intakes. Patients with elevated AGE had higher intravenous carbohydrate intakes (median 3.3g/kg/day [1.84;3.62]), compared to patients with normal AGE (1.79g/kg/d [1.45;2.26], p=0.03). The presence of chronic renal failure was also associated with elevated AGE. This preliminary study suggests that AGE accumulation is increased in subjects on prolonged parenteral nutrition. Studies with larger numbers will be necessary to confirm this hypothesis and to evaluate the association with cardiovascular events.