Laboratorio no. 6. Edif. Consultas externas (planta -2), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Travesía da Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain.
CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
Cardiovasc Diabetol. 2017 Sep 15;16(1):115. doi: 10.1186/s12933-017-0598-3.
The role of advanced glycation end products (AGEs) and their soluble receptor (sRAGE) on the progression and prognosis of acute heart failure (HF) was analysed in relation with metabolic parameters as body composition and nutritional status.
A hundred and fifty consecutive patients were included in a prospective clinical study during hospitalization by acute HF. Detailed medical history, physical examination, electrocardiogram, echocardiogram and vein peripheral blood were taken for all patients. During the follow-up period [297 days (88-422 days)] blood samples for biochemical measurements were obtained 1 and 6 months after the inclusion. Dual-energy X-ray absorptiometry analyses were performed 1 week after discharge.
AGEs and sRAGE levels continuously increased, up to 6 months, after acute HF, but AGEs increase was mainly observed in those patients with incident HF. Both AGEs and sRAGE levels were related with bad renal function and clinical malnutrition (CONUT score) and they were negatively related with body mass index or percentage of body fat. AGEs levels (≥40 a.u.) 1 month after discharge and basal sRAGE levels (>1000 pg/mL) were related with worse prognosis in terms of patient death and HF readmission (Log-rank <0.05 in Kaplan-Meier survival test), independently of age, gender, body mass index and other risk factors. Regression models also corroborated this finding.
AGEs and sRAGE are bad prognostic biomarkers for HF and useful markers of HF progression. Since their levels seem to be related with clinical malnutrition and body composition these parameters could serve to modulate them.
分析晚期糖基化终产物（AGEs）及其可溶性受体（sRAGE）与代谢参数（如身体成分和营养状况）在急性心力衰竭（HF）进展和预后中的作用。
150 例连续患者在急性 HF 住院期间通过前瞻性临床研究纳入。所有患者均接受详细的病史、体格检查、心电图、超声心动图和外周静脉血检查。在随访期间[297 天（88-422 天）]，在纳入后 1 和 6 个月获得生化测量的血液样本。出院后 1 周进行双能 X 射线吸收法分析。
急性 HF 后，AGEs 和 sRAGE 水平持续升高，直至 6 个月，但仅在新发 HF 患者中观察到 AGEs 升高。AGEs 和 sRAGE 水平均与肾功能不良和临床营养不良（CONUT 评分）有关，且与体重指数或体脂百分比呈负相关。出院后 1 个月 AGEs 水平（≥40 a.u.）和基础 sRAGE 水平（>1000 pg/mL）与患者死亡和 HF 再入院的预后较差相关（在 Kaplan-Meier 生存试验中的对数秩检验<0.05），独立于年龄、性别、体重指数和其他危险因素。回归模型也证实了这一发现。
AGEs 和 sRAGE 是 HF 的不良预后生物标志物，也是 HF 进展的有用标志物。由于它们的水平似乎与临床营养不良和身体成分有关，这些参数可以用于调节它们。
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