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晚期糖基化终末产物(AGEs)及其可溶性受体(sRAGE)作为2型糖尿病控制不佳患者肾血管并发症的早期预测指标。

Advanced glycation end products (AGEs) and their soluble receptors (sRAGE) as early predictors of reno-vascular complications in patients with uncontrolled type 2 diabetes mellitus.

作者信息

Farhan Sinan Subhi, Hussain Saad Abdulrahmann

机构信息

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq.

出版信息

Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2457-2461. doi: 10.1016/j.dsx.2019.06.019. Epub 2019 Jun 28.

Abstract

AIM

To evaluate the role of advanced glycation end-products (AGEs) and their soluble receptors (sRAGE) expression levels as predictors of vascular complications in uncontrolled type 2 diabetes mellitus (T2DM).

METHODS

Cross-sectional study was conducted on T2DM adults of both sexes who attended the outpatient service of Al-Karak Teaching Hospital, Jordan during the period from June 2017 to August 2018. Participants were categorized in two groups according to their glycemic control and the presence of reno-vascular complications. Twenty healthy subjects were recruited as control group. Blood sample was obtained from all participants and used for the assessment of FBG, HbA1c, serum AGEs and sRAGE, serum urea and creatinine; 24 h urine was also collected for the determination of urinary albumin.

RESULTS

Diabetic subjects with vascular complication had a significantly higher serum AGEs 50.3 ± 13 vs. 28.9 ± 8 pg/ml) and AGEs/sRAGE ratio (0.058 ± 0.02 vs. 0.037 ± 0.02) associated with significantly lower serum sRAGE (868.7 ± 50.8 vs. 912.8 ± 294.3) compared to those with no complications. Serum AGEs and sRAGE showed weak negative and non-significant association in both groups of patients. However, the AGEs/sRAGE ration was inversely and significantly associated with the urinary albumin/creatinine ratio (r = - 0.51, P = 0.009) only in DM patients with reno-vascular complications.

CONCLUSION

We found an association between AGEs/sRAGE ratio and urinary albumin/serum creatinine ratio in T2DM patients with reno-vascular complications; providing evidence that serum AGEs and sRAGE can be considered as predictors of vascular complications in uncontrolled T2DM patients.

摘要

目的

评估晚期糖基化终末产物(AGEs)及其可溶性受体(sRAGE)表达水平作为未控制的2型糖尿病(T2DM)血管并发症预测指标的作用。

方法

对2017年6月至2018年8月期间在约旦卡拉克教学医院门诊就诊的成年T2DM患者进行横断面研究。根据血糖控制情况和是否存在肾血管并发症将参与者分为两组。招募20名健康受试者作为对照组。采集所有参与者的血样,用于评估空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血清AGEs和sRAGE、血清尿素和肌酐;同时收集24小时尿液用于测定尿白蛋白。

结果

与无并发症的糖尿病患者相比,有血管并发症的糖尿病患者血清AGEs显著更高(50.3±13 vs. 28.9±8 pg/ml),AGEs/sRAGE比值显著更高(0.058±0.02 vs. 0.037±0.02),而血清sRAGE显著更低(868.7±50.8 vs. 912.8±294.3)。两组患者血清AGEs和sRAGE均呈弱负相关且无统计学意义。然而,仅在有肾血管并发症的糖尿病患者中,AGEs/sRAGE比值与尿白蛋白/肌酐比值呈显著负相关(r = -0.51,P = 0.009)。

结论

我们发现有肾血管并发症的T2DM患者中AGEs/sRAGE比值与尿白蛋白/血清肌酐比值之间存在关联;这表明血清AGEs和sRAGE可被视为未控制的T2DM患者血管并发症的预测指标。

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