title: Association of serum soluble receptor for advanced glycation end-products with subclinical cerebrovascular disease: the Northern Manhattan Study (NOMAS).
abstract: OBJECTIVE
  Serum levels of the soluble receptor for advanced glycation end-products (sRAGE) have been associated with risk of cardiovascular disease. We hypothesized that sRAGE levels are associated with subclinical cerebrovascular disease in an ethnically diverse population.
  
  
  METHODS
  Clinically stroke-free participants in the multi-ethnic Northern Manhattan Study (NOMAS) underwent brain MRI to quantify subclinical brain infarcts (SBI) and white matter hyperintensity volume (WMHV) (n = 1102). Serum levels of sRAGE were measured by ELISA. Logistic and multiple linear regression were employed to estimate associations of sRAGE with SBI and WMHV, after adjusting for demographics and vascular risk factors.
  
  
  RESULTS
  Median sRAGE levels were significantly lower in Hispanics (891.9 pg/ml; n = 708) and non-Hispanic blacks (757.4 pg/ml; n = 197) than in non-Hispanic whites (1120.5 pg/ml; n = 170), and these differences remained after adjusting for other risk factors. Interactions were observed by race-ethnicity between sRAGE levels and MRI measurements, including for SBI in Hispanics (p = 0.04) and WMHV among blacks (p = 0.03). In Hispanics, increasing sRAGE levels were associated with a lower odds of SBI, with those in the upper sRAGE quartile displaying a 50% lower odds of SBI after adjusting for sociodemographic and vascular risk factors (p = 0.05). Among blacks, those in the upper quartile of sRAGE had a similarly reduced increased risk of SBI (p = 0.06) and greater WMHV (p = 0.04).
  
  
  CONCLUSIONS
  Compared to whites, Hispanics and blacks have significantly lower sRAGE levels, and these levels were associated with more subclinical brain disease. Taken together, these findings suggest sRAGE levels may be significantly influence by ethnicity. Further studies of sRAGE and stroke risk, particularly in minorities, are warranted.
authors.affiliation: Division of Surgical Science, Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA. bhudson@med.miami.edu
authors.forename: Barry I
authors.initials: BI
authors.lastname: Hudson
authors.forename: Yeseon Park
authors.initials: YP
authors.lastname: Moon
authors.forename: Anastasia Z
authors.initials: AZ
authors.lastname: Kalea
authors.forename: Minesh
authors.initials: M
authors.lastname: Khatri
authors.forename: Chensy
authors.initials: C
authors.lastname: Marquez
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Schmidt
authors.forename: Myunghee C
authors.initials: MC
authors.lastname: Paik
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshita
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Charles
authors.initials: C
authors.lastname: DeCarli
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000208:ethnology* / Q000473:pathology; D015536:Down-Regulation; D004797:Enzyme-Linked Immunosorbent Assay; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic