Koyama Hidenori, Shoji Tetsuo, Fukumoto Shinya, Shinohara Kayo, Shoji Takuhito, Emoto Masanori, Mori Katsuhito, Tahara Hideki, Ishimura Eiji, Kakiya Ryusuke, Tabata Tsutomu, Yamamoto Hiroshi, Nishizawa Yoshiki
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Arterioscler Thromb Vasc Biol. 2007 Jan;27(1):147-53. doi: 10.1161/01.ATV.0000251502.88818.4b. Epub 2006 Nov 2.
Receptor for advanced glycation end-products (RAGE) is involved in diabetic vascular complications. We have recently shown that plasma endogenously secretory RAGE (esRAGE), an alternatively spliced form of RAGE, is closely associated with metabolic syndrome and atherosclerosis. Here, we evaluated if plasma esRAGE is a predictor of cardiovascular mortality in a cohort of 206 (171 nondiabetic) patients with end-stage renal diseases (ESRD).
The cohort was followed for a median of 111 months, and 74 deaths including 34 cardiovascular deaths were recorded. Plasma esRAGE was measured at baseline. Cumulative incidence of cardiovascular death by Kaplan-Meier estimation was significantly higher in subjects in the lowest tertile of plasma esRAGE than those in the middle or the highest tertile both in all and nondiabetic subjects alone. In all subjects, as compared with the lowest tertile of plasma esRAGE, the hazards ratios for the highest and middle tertile were 0.40 (95% CI, 0.18 to 0.89) and 0.26 (0.10 to 0.66), respectively. The higher risk for lower esRAGE was still significant even after adjusted either with body mass index, hypertension, dyslipidemia and vascular complications, but was confounded by age and diabetes.
Low circulating esRAGE is a predictor for cardiovascular mortality in ESRD patients.
晚期糖基化终末产物受体（RAGE）参与糖尿病血管并发症的发生。我们最近发现，血浆内源性分泌型RAGE（esRAGE）是RAGE的一种可变剪接形式，与代谢综合征和动脉粥样硬化密切相关。在此，我们评估了在206例（171例非糖尿病患者）终末期肾病（ESRD）患者队列中，血浆esRAGE是否为心血管死亡的预测指标。
该队列随访时间中位数为111个月，记录到74例死亡，其中包括34例心血管死亡。在基线时检测血浆esRAGE。通过Kaplan-Meier估计法得出的心血管死亡累积发生率在血浆esRAGE处于最低三分位数的受试者中显著高于处于中间或最高三分位数的受试者，无论是在所有受试者中还是仅在非糖尿病受试者中均如此。在所有受试者中，与血浆esRAGE最低三分位数相比，最高和中间三分位数的风险比分别为0.40（95%CI，0.18至0.89）和0.26（0.10至0.66）。即使在对体重指数、高血压、血脂异常和血管并发症进行校正后，较低esRAGE导致的较高风险仍然显著，但受年龄和糖尿病的影响。
循环esRAGE水平低是ESRD患者心血管死亡的预测指标。
