Soluble receptor for advanced glycation end products and its role in cardiovascular risk assessment in hyperglycemia - A study in North India.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.