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Nutrients
Volume 12
Issue 8
10.3390/nu12082377
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Article
Peer-Review Record

Dietary Advanced Glycation End-Products (dAGEs) Intake and Bone Health: A Cross-Sectional Analysis in the Rotterdam Study

Nutrients 2020, 12(8), 2377; https://doi.org/10.3390/nu12082377
by Komal Waqas 1, Jinluan Chen 1,2, Bram C. J. van der Eerden 1, M. Arfan Ikram 2, André G. Uitterlinden 1,2, Trudy Voortman 2 and M. Carola Zillikens 1,*
Reviewer 1: Anonymous
Reviewer 2: Anonymous
Nutrients 2020, 12(8), 2377; https://doi.org/10.3390/nu12082377
Submission received: 30 June 2020 / Revised: 1 August 2020 / Accepted: 6 August 2020 / Published: 8 August 2020
(This article belongs to the Special Issue The Impact of Vitamins, Minerals and Functional Foods on Bone Health)

Round 1

Reviewer 1 Report

This is an interesting manuscript that investigates the association between dietary advanced glycation end-products and bone measures. There are a few questions for the authors:

  1. Regarding the sentence: “All scans were 178 performed and verified by a trained technician who applied adjustments when necessary.” What kind of adjustments were applied? Could a little more detail be included here?
  2. What version of the TBS iNsight software was used to calculate TBS?
  3. Regarding the sentence: “Fractures were included if they are a component of major osteoporotic fractures (MOF) which includes a fracture of the hip, vertebra (clinical), wrist or humerus.” These appear to be the FRAX definition of major osteoporotic fractures, which includes the proximal humerus, but not other regions of the humerus. Were steps taken to only include proximal humerus fractures? Or were all humerus fractures included?
  4. For T2DM, were there any participants who had T1DM? Were the authors able to determine what type of diabetes each participant had?
  5. Could the authors provide some examples of what foods are included in the “sweets” category? The other groups are self-explanatory.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The Authors investigated the association between dietary AGE (Carboxymethyllysine,  CML) obtained from food frequency questionnaires and bone health. Particularly, they considered measurements of bone mineral density, prevalent major osteoporotic fractures and vertebral fractures.

This cross-sectional study is based on a large sample size and the data analysis is well carried out.

The results are original and highlight a positive association between dietary CML intake and prevalence of vertebral fractures. However, dietary AGEs  intake was not significantly associated with bone mineral density or the novel index of bone quality named Trabecular Bone Score.

The authors may speculate in their discussion about the association (not investigated) between AGEs and other surrogate of bone strengths, such us Quantitative UltraSound measurements of bone or Quantitative Computed Tomography evaluation (e.g.  Clin Cases Miner Bone Metab. 2013;10(3):191-194;  J Diabetes Res. 2020;2020:7608964. doi:10.1155/2020/7608964; J Clin Endocrinol Metab. 2020;105(1):dgz036. doi:10.1210/clinem/dgz036).

Moreover, the Authors should specify whether participants were under particular treatments influencing bone health, or alternatively include this point as a limitation of the study if data are not known.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

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