Low circulating endogenous secretory receptor for AGEs predicts cardiovascular mortality in patients with end-stage renal disease.
OBJECTIVE
Receptor for advanced glycation end-products (RAGE) is involved in diabetic vascular complications. We have recently shown that plasma endogenously secretory RAGE (esRAGE), an alternatively spliced form of RAGE, is closely associated with metabolic syndrome and atherosclerosis. Here, we evaluated if plasma esRAGE is a predictor of cardiovascular mortality in a cohort of 206 (171 nondiabetic) patients with end-stage renal diseases (ESRD).


RESULTS
The cohort was followed for a median of 111 months, and 74 deaths including 34 cardiovascular deaths were recorded. Plasma esRAGE was measured at baseline. Cumulative incidence of cardiovascular death by Kaplan-Meier estimation was significantly higher in subjects in the lowest tertile of plasma esRAGE than those in the middle or the highest tertile both in all and nondiabetic subjects alone. In all subjects, as compared with the lowest tertile of plasma esRAGE, the hazards ratios for the highest and middle tertile were 0.40 (95% CI, 0.18 to 0.89) and 0.26 (0.10 to 0.66), respectively. The higher risk for lower esRAGE was still significant even after adjusted either with body mass index, hypertension, dyslipidemia and vascular complications, but was confounded by age and diabetes.


CONCLUSIONS
Low circulating esRAGE is a predictor for cardiovascular mortality in ESRD patients.
Koyama
Hidenori
H
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. hidekoyama@med.osaka-cu.ac.jp
Shoji
Tetsuo
T
Fukumoto
Shinya
S
Shinohara
Kayo
K
Shoji
Takuhito
T
Emoto
Masanori
M
Mori
Katsuhito
K
Tahara
Hideki
H
Ishimura
Eiji
E
Kakiya
Ryusuke
R
Tabata
Tsutomu
T
Yamamoto
Hiroshi
H
Nishizawa
Yoshiki
Y
D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
D017127:Glycation End Products, Advanced