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ludc web

Stina Ramne


ludc web

Dietary intake of advanced glycation endproducts and risk of hepatobiliary cancers : a multinational cohort study


  • Ana-Lucia Mayén
  • Elom K Aglago
  • Viktoria Knaze
  • Reynalda Cordova
  • Casper G Schalkwijk
  • Karl-Heinz Wagner
  • Krasimira Aleksandrova
  • Veronika Fedirko
  • Pekka Keski-Rahkonen
  • Michael F Leitzmann
  • Verena Katzke
  • Bernard Srour
  • Matthias B Schulze
  • Giovanna Masala
  • Vittorio Krogh
  • Salvatore Panico
  • Rosario Tumino
  • Bas Bueno-de-Mesquita
  • Magritt Brustad
  • Antonio Agudo
  • María Dolores Chirlaque López
  • Pilar Amiano
  • Bodil Ohlsson
  • Stina Ramne
  • Dagfinn Aune
  • Elisabete Weiderpass
  • Mazda Jenab
  • Heinz Freisling

Summary, in English

Advanced glycation endproducts (AGEs) may contribute to liver carcinogenesis because of their pro-inflammatory and pro-oxidative properties. Diet is a major source of AGEs, but there is sparse human evidence on the role of AGEs intake in liver cancer aetiology. We examined the association between dietary AGEs and the risk of hepatobiliary cancers in the European Prospective Investigation into Cancer and Nutrition prospective cohort (n=450,111). Dietary intake of three AGEs, Nε -[carboxymethyl]lysine (CML), Nε -[1-carboxyethyl]lysine (CEL), and Nδ -[5-hydro-5-methyl-4-imidazolon-2-yl]-ornithine (MG-H1), was estimated using country-specific dietary questionnaires linked to an AGEs database. Cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations between dietary AGEs and risk of hepatocellular carcinoma (HCC), gallbladder, and biliary tract cancers were estimated using multivariable Cox proportional hazard regression. After a median follow-up time of 14.9 years, 255 cases of HCC, 100 cases of gallbladder cancer, and 173 biliary tract cancers were ascertained. Higher intakes of dietary AGEs were inversely associated with risk of HCC (per 1 standard deviation [SD] increment, HR-CML =0.87, 95% CI: 0.76 to 0.99, HR-CEL =0.84, 95% CI: 0.74 to 0.96, and HR-MH-G1 = 0.84, 95% CI: 0.74 to 0.97). In contrast, positive associations were observed with risk of gallbladder cancer (per 1 SD, HR-CML =1.28, 95% CI: 1.05 to 1.56, HR-CEL =1.17; 95% CI: 0.96 to 1.40, HR-MH-G1 =1.27, 95% CI: 1.06 to 1.54). No associations were observed for cancers of the intra- and extra-hepatic bile ducts. Our findings suggest that higher intakes of dietary AGEs are inversely associated with the risk of HCC and positively associated with the risk of gallbladder cancer.


  • Internal Medicine - Epidemiology
  • Nutrition Epidemiology
  • EpiHealth: Epidemiology for Health

Publishing year







International Journal of Cancer





Document type

Journal article


John Wiley & Sons Inc.


  • Public Health, Global Health, Social Medicine and Epidemiology



Research group

  • Internal Medicine - Epidemiology
  • Nutrition Epidemiology


  • ISSN: 0020-7136