Lower Serum Endogenous Secretory Receptor for Advanced Glycation End Product Level as a Risk Factor of Metabolic Syndrome Among Japanese Adult Men: A 2-Year Longitudinal Study

Abstract

Receptor for advanced glycation end products (RAGE) activation by its ligands is implicated in obesity-related metabolic disease and accelerated atherothrombosis. Circulating soluble (sRAGE) and/or endogenous secretory RAGE (esRAGE) may counteract the detrimental effects of RAGE. This study aimed at determining the relationship between circulating RAGE and metabolic syndrome (MetS) incidence among Japanese adult men. This 2-year longitudinal study included 426 Japanese men aged 30-83 years who had no MetS at baseline. Serum esRAGE and sRAGE were assayed by ELISA at baseline. Incident metabolic syndrome, defined according to the Asian cutoff based on the 2009 criteria of the American Heart Association Scientific Statements, was evaluated after the 2-year follow-up. During the follow-up period, 55 participants (12.9%) had newly diagnosed MetS. In the multiple logistic models comparing MetS risk in the lowest with that in the highest tertile of baseline esRAGE, a high serum esRAGE level was found to be significantly associated with a low risk of MetS [odds ratios (95% confidence interval), 0.37 (0.14-0.95); P for trend = 0.038] after adjusting for lifestyle and sociodemographic factors, serum high-sensitivity C-reactive protein level, estimated glomerular filtration rate, and MetS components at baseline. Although sRAGE and esRAGE were strongly correlated (r(s) = 0.88), the sRAGE level was not associated with MetS incidence. A high circulating esRAGE level, but not sRAGE level, was associated with a low MetS incidence among Japanese adult men.