Endogenous soluble receptor for advanced glycation endproducts is increased in preeclampsia.
OBJECTIVE
Preeclampsia is a serious complication in pregnancy with an increased future cardiovascular risk for both mother and newborn. Recently, low levels of endogenous soluble receptor for advanced glycation endproducts (esRAGE) have been associated with increased cardiovascular risk. In the current study, we investigated esRAGE serum levels in patients with preeclampsia as compared to healthy gestational age-matched controls.


METHODS
esRAGE was quantified by enzyme-linked immunosorbent assay in controls and patients with preeclampsia during pregnancy (control: n = 20, preeclampsia: n = 16) and 6 months after delivery (control: n = 19, preeclampsia: n = 15). Furthermore, esRAGE was correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation.


RESULTS
During pregnancy, median maternal serum esRAGE concentrations were more than three-fold higher in patients with preeclampsia (200 ng/l) than in controls (63 ng/l) (P < 0.01). Furthermore, esRAGE levels positively correlated with age, blood pressure, creatinine, adiponectin, and C-reactive protein, whereas a negative correlation existed with fasting insulin and the homeostasis model assessment of insulin resistance index. In multivariate analyses, homeostasis model assessment of insulin resistance and C-reactive protein independently predicted esRAGE serum levels and explained 44% of the variation in esRAGE concentrations. Surprisingly, median esRAGE concentrations 6 months after delivery were significantly lower in former patients with preeclampsia (270 ng/l) than in controls (342 ng/l) in contrast to the results obtained during pregnancy.


CONCLUSIONS
We showed that maternal esRAGE concentrations are significantly increased in patients with preeclampsia during pregnancy. Here, insulin sensitivity and inflammatory status independently predict serum esRAGE levels.
Fasshauer
Mathias
M
Department of Internal Medicine III, University of Leipzig, Ph.-Rosenthal Strasse 27, Leipzig, Germany. mathias.fasshauer@medizin.uni-leipzig.de
Seeger
Jeannette
J
Waldeyer
Theresa
T
Schrey
Susanne
S
Ebert
Thomas
T
Lossner
Ulrike
U
Bluher
Matthias
M
Stumvoll
Michael
M
Faber
Renaldo
R
Stepan
Holger
H
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D001793:Blood Preservation; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood* / Q000175:diagnosis*; D007333:Insulin Resistance; D015999:Multivariate Analysis; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D055815:Young Adult
C499918:ADIPOQ protein, human; D052242:Adiponectin; D017127:Glycation End Products, Advanced; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; D002097:C-Reactive Protein; D003404:Creatinine