CNR Institute of Clinical Physiology, Pisa, Italy.
Kidney Int. 2010 Feb;77(3):225-31. doi: 10.1038/ki.2009.419. Epub 2009 Nov 18.
The soluble receptor of advanced glycation end product (sRAGE) prevents vascular damage in experimental animal models, and observational studies in the general population support the hypothesis that sRAGE may exert a protective role on the vasculature. To test this in patients with chronic kidney disease, we determined the relationship between plasma sRAGE and carotid atherosclerosis in 142 patients with an average estimated glomerular filtration rate (eGFR) of 32 ml/min per 1.73 m(2) and 49 healthy control individuals matched for age and gender. Plasma sRAGE was significantly higher in patients with chronic kidney disease than in the control cohort. In an aggregate analysis of the patients and controls, there was a significant inverse relationship between eGFR and sRAGE, with a breakpoint in the regression line at 64 ml/min per 1.73 m(2). Significant inverse relationships were found for sRAGE to intima-media thickness and plaque number in the patients with chronic kidney disease, but no such associations were found in the controls. On covariance analysis, the slopes of intima-media thickness and plaque number to sRAGE were significantly steeper in patients with chronic kidney disease than in the controls. Furthermore, a significant interaction was found between sRAGE and smoking for predicting atherosclerotic plaques in patients with chronic kidney disease. The pathophysiological significance of this correlation will have to await more mechanistic studies.
可溶性晚期糖基化终产物受体（sRAGE）可预防实验动物模型中的血管损伤，而一般人群的观察性研究支持 sRAGE 可能对血管发挥保护作用的假说。为了在慢性肾脏病患者中验证这一点，我们在 142 名平均估算肾小球滤过率（eGFR）为 32ml/min/1.73m²的患者和 49 名年龄和性别匹配的健康对照者中，测定了血浆 sRAGE 与颈动脉粥样硬化之间的关系。与对照组相比，慢性肾脏病患者的血浆 sRAGE 明显升高。在患者和对照组的综合分析中，eGFR 与 sRAGE 之间存在显著的负相关关系，在 64ml/min/1.73m² 处回归线出现拐点。在慢性肾脏病患者中，sRAGE 与内膜-中层厚度和斑块数量之间存在显著的负相关关系，但在对照组中未发现这种相关性。在协方差分析中，慢性肾脏病患者的内膜-中层厚度和斑块数量与 sRAGE 的斜率明显比对照组陡峭。此外，在慢性肾脏病患者中，sRAGE 与吸烟之间存在显著的交互作用，可预测动脉粥样斑块。这种相关性的病理生理意义尚需更多的机制研究来证实。
