Gupta Aparna, Goyal Parul, Roy Smita, Jana Pratip, Chauhan Ajay, Jilowa Sarita, Panghal Yashasvi
Department of Biochemistry, Lady Hardinge Medical College and Associated Hospitals, University of Delhi, New Delhi, India.
Department of Biochemistry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Guru Gobind Singh Indraprastha University, New Delhi, India.
J Family Med Prim Care. 2025 Apr;14(4):1325-1332. doi: 10.4103/jfmpc.jfmpc_1356_24. Epub 2025 Apr 25.
Advanced glycation end products (AGEs) and their cellular receptors (RAGEs) play an important role in the pathogenesis of type 2 diabetes mellitus and its progression to cardiovascular disease (CVD). A marker of the AGE-RAGE axis, soluble RAGE (sRAGE), was examined in this study in various glycemic states as well as in low- and high-CVD-risk patients.
In this cross-sectional study, 25 adults were recruited into each of the "Normoglycemic", "Prediabetic", and "Diabetic" groups based on American Diabetes Association 2019 HbA1c% level criteria. Using online American Heart Association Atherosclerotic CVD (AHA ASCVD) risk calculator and guidelines, patients were classified into "Low" and "High" risk categories. Serum sRAGE was assayed using sandwich ELISA technology. Serum markers necessary for calculation of homeostatic model assessment for insulin resistance (HOMA-IR) and atherogenic index of plasma (AIP) were spectrophotometrically estimated. Carotid intima-media thickness (CIMT) was analyzed using B-mode carotid ultrasonography.
Mann-Whitney U analysis showed that sRAGE, AIP, HOMA-IR, CIMT, and %10-year CVD risk values were significantly different in the two ASCVD risk categories. Spearman test showed a significant correlation between sRAGE and other markers. ROC curve analysis demonstrated a higher area under the curve for sRAGE than other known parameters to differentiate between ASCVD risk categories. Finally, odds ratio analysis showed that sRAGE had higher odds of detecting high CVD risk than AIP or CIMT.
Our study has demonstrated the possible role of sRAGE in CVD development and suggests that they may serve as screening markers for future CVD risk.
晚期糖基化终产物（AGEs）及其细胞受体（RAGEs）在2型糖尿病发病机制及其向心血管疾病（CVD）进展过程中发挥重要作用。本研究在不同血糖状态以及低CVD风险和高CVD风险患者中检测了AGE-RAGE轴的标志物可溶性RAGE（sRAGE）。
在这项横断面研究中，根据美国糖尿病协会2019年HbA1c%水平标准，将25名成年人纳入“血糖正常”、“糖尿病前期”和“糖尿病”组。使用美国心脏协会在线动脉粥样硬化性CVD（AHA ASCVD）风险计算器和指南，将患者分为“低”风险和“高”风险类别。采用夹心ELISA技术检测血清sRAGE。采用分光光度法估算计算胰岛素抵抗稳态模型评估（HOMA-IR）和血浆致动脉粥样硬化指数（AIP）所需的血清标志物。使用B型颈动脉超声分析颈动脉内膜中层厚度（CIMT）。
Mann-Whitney U分析显示，在两个ASCVD风险类别中，sRAGE、AIP、HOMA-IR、CIMT和10年CVD风险百分比值存在显著差异。Spearman检验显示sRAGE与其他标志物之间存在显著相关性。ROC曲线分析表明，sRAGE的曲线下面积高于其他已知参数，可用于区分ASCVD风险类别。最后，比值比分析显示，与AIP或CIMT相比，sRAGE检测到高CVD风险的几率更高。
我们的研究证明了sRAGE在CVD发展中的可能作用，并表明它们可能作为未来CVD风险的筛查标志物。
