218 0.069 <0.01 Adjusted for age, body mass index, calcium intake, physical activity level, smoking status, education level, and metabolic syndrome AF autofluorescence, OSI osteo-sono assessment index, SE standard error Table 4 Relationship of the tertile of skin autofluorescence (AF) with log-transformed

OSI among adult Japanese men   Tertiles of skin AF Range (unit, AU) Low Middle High (1.28–1.82) (1.82–2.05) (2.05–2.88) Number of participants 65 64 64 Crude 2.83 (2.76–2.90) 2.78 (2.71–2.85) learn more 2.68 (2.61–2.74)* Adjusteda 2.81 (2.75–2.87) 2.81 (2.74–2.87) 2.66(2.61–2.73)*,** Data are geometric means (95% confidence interval). Unit of leg extension power is watts per kilogram Analysis of variance or analysis of covariance * P < 0.01; significantly different from lowest skin autofluorescence tertile (Bonferroni correction) ** P < 0.01; significantly different from middle skin autofluorescence tertile (Bonferroni correction) aAdjusted for age, body mass index, calcium intake, physical activity level, smoking status, education level, and metabolic syndrome Discussion The present study examined the relationship between skin AF associated with AGE accumulation and OSI, a quantitative ultrasound measure, among

non-diabetic adult Japanese men. Consistent with our hypothesis, our results showed that levels of skin AF were independently associated with OSI, suggesting that participants

with higher skin AF had lower OSI. In previous population studies, the relationship between AGE accumulation A-1155463 cost and fracture risk has been controversial. Some studies reported that there was no association between urinary pentosidine and fracture risk after adjustment in non-diabetic older Caucasian [14] Glutathione peroxidase and among postmenopausal Caucasian women [27]. On the other hand, in elderly Japanese women, a high level of urinary pentosidine was an independent risk factor for osteoporotic vertebral fractures [13]. Possibly in line with these findings, we found a negative association between skin AF with OSI among adult Japanese men after adjustment for potential confounders, given that lower OSI may lead to higher fracture risk. Although the reasons for this discrepancy are unknown, racial differences may potentially explain the inconsistent results of the studies. While Japanese have twice the incidence of the methylenetetrahydrofolate Stem Cells inhibitor reductase polymorphism (C677T) compared with Caucasians, Japanese subjects are predisposed to mild hyperhomocysteinemia [28–30]. Indeed, hyperhomocysteinemia caused a reduction in bone toughness through the accumulation of pentosidine in bone in rabbit models [31]. Other explanation could be diet, which is a major source of exogenous AGEs [32].