Relationship Between Serum HMGB1 and RAGE Levels and Restenosis in Type 2 Diabetes Mellitus Patients Complicated With Lower Extremity Vascular Disease: A Retrospective Study.

Purpose: To investigate the potential association between the serum concentrations of high mobility group protein B1 (HMGB1) and the receptor for advanced glycation end-products (RAGE) in relation to the occurrence of restenosis following interventional therapy for lower extremity vascular disease in patients diagnosed with type 2 diabetes mellitus (T2DM).

Patients and methods: From March 2023 to January 2024, 96 T2DM patients with lower extremity vascular disease who underwent interventional therapy and 6-month follow-up in our hospital were studied. Patients were divided into in-stent restenosis (ISR) (n=38) and none-in-stent restenosis (NISR) (n=58) groups based on the occurrence of ISR. Pre-surgery demographics and serum levels of HMGB1, RAGE, glycated hemoglobin (HbA1c), and high-sensitivity C-reactive protein (hs-CRP) were analyzed. A Pearson correlation and multivariate Logistic regression were used to identify factors influencing restenosis. A predictive nomogram was built based on the identified factors. The receiver operating characteristic (ROC) curve analysis evaluated the predictive value of serum RAGE and HMGB1 for restenosis post-intervention.

Results: The ISR group exhibited statistically significant elevations in HbA1c, hs-CRP, HMGB1, and RAGE levels compared to the NISR group (P<0.05). Multivariate logistic regression analysis revealed that HMGB1 and RAGE were independent risk factors for restenosis in T2DM patients with lower extremity vascular disease undergoing interventional therapy. The predictive nomogram model developed specifically for this patient population demonstrated high accuracy. ROC curve analysis further emphasized the superior combined predictive value of HMGB1 and RAGE over individual biomarkers for restenosis after interventional therapy in this cohort.

Conclusion: Elevated preoperative serum levels of HMGB1 and RAGE in T2DM patients with lower extremity vascular disease are linked to restenosis following interventional therapy.