Abstract
BackgroundSoluble receptor for advanced glycation end-products (sRAGE) and advanced glycation end-products (AGE) have been associated with risks of cardiovascular disease. Because sRAGE is regarded as a scavenger to AGE, we hypothesized that the ratio of AGE to sRAGE (AGE/sRAGE) is associated with albuminuria in hypertensive patients.MethodsIn this cross-sectional study, a total of 104 patients with essential hypertension were recruited. Hypertension was defined as a systolic blood pressure ≥ 140 mmHg, a diastolic blood pressure ≥ 90 mmHg, or use of antihypertensive treatment. Albuminuria was defined as albumin excretion rate ≧ 20 μg/min. Multivariate logistic regression analyses were performed to evaluate the association between AGE/sRAGE and albuminuria.ResultsAmong the 104 patients, 30 (28.8%) patients had albuminuria and 74 (71.2%) patients did not. Patients with albuminuria had higher AGE (2.15 vs. 1.71 μg/mL), lower sRAGE (424.5 vs. 492.5 pg/ml) and higher AGE/sRAGE (3.79 vs. 3.29 μg/pg) than those without albuminuria. Multivariate logistic regression model revealed that AGE/sRAGE (OR = 1.131, 95% CI = 1.001–1.278, P = 0.048) was independently associated with albuminuria. There was no significant relationship between AGE and sRAGE alone with albuminuria.ConclusionThis study suggests that the ratio of AGE to sRAGE may be a surrogate biomarker for microvascular injury. Further prospective studies of the prognostic value of the ratio in relation to microvasular injury are needed.
Highlights
Soluble receptor for advanced glycation end-products and advanced glycation end-products (AGE) have been associated with risks of cardiovascular disease
Because current evidence implied that identifying novel biomarkers which is associated with albuminuria is possibly a way to find a surrogate for early evaluation of future cardiovascular risk, this study aimed to test the hypothesis that increased AGE/Soluble receptor for advanced glycation end-products (sRAGE) may associate with the existence of albuminuria in patients with essential hypertension
The results of multivariate logistic regression models revealed that number of drugs, NT-proBNP (OR = 1.015, 95% CI = 1.001–1.030, P = 0.030), and AGE/ sRAGE (OR = 1.131, 95% CI = 1.001–1.278, P = 0.048) were independently associated with albuminuria (Table 2)
Summary
Soluble receptor for advanced glycation end-products (sRAGE) and advanced glycation end-products (AGE) have been associated with risks of cardiovascular disease. The association between albuminuria and several cardiovascular risk factors has been widely demonstrated [1]. The existence of albuminuria is associated with signs of subclinical end-organ damage [2, 3] and is a strong indicator of microvascular damage in patients with essential hypertension [4]. The interaction of AGE and receptor for advanced glycation end-products (RAGE) on the membrane of endothelial cells can activate intracellular signal cascade, elicit reactive oxygen species production, activate nuclear factor-κB, and increase gene expression and release of inflammatory cytokines, resulting in the progression of atherosclerosis [9]. Animal models have showed that inhibiting AGE-RAGE axis by sRAGE could attenuate the development and progression of cerebrovascular and cardiovascular disease [11, 12]
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