title: Plasma levels of soluble receptor for advanced glycation end products (sRAGE) and proinflammatory ligand for RAGE (EN-RAGE) are associated with carotid atherosclerosis in patients with peritoneal dialysis.
abstract: OBJECTIVE
  The soluble receptor for advanced glycation end products (sRAGE) exerts a protective effect on the development of atherosclerotic vascular complications by inhibiting RAGE-mediated inflammatory response. In contrast, extracellular newly identified RAGE-binding protein (EN-RAGE) contributes to increased atherosclerosis as a pro-inflammatory ligand for RAGE. We determined the levels of sRAGE and EN-RAGE in peritoneal dialysis (PD) patients and evaluated their relationship with carotid atherosclerosis.
  
  
  METHODS
  A cross-sectional study was performed in 91 PD patients and 29 control subjects. Carotid IMT (cIMT) and abdominal aortic vascular calcification score (VCS) were evaluated using high-resolution B-mode ultrasonography and plain radiographic film of the lateral abdomen.
  
  
  RESULTS
  Plasma sRAGE and EN-RAGE levels were more than twice as higher in PD patients compared to controls. EN-RAGE showed a strong positive correlation with serum high-sensitivity CRP (p=0.007) and IL-6 (p=0.002), whereas sRAGE was negatively associated with those inflammatory markers (p=0.001, p=0.031). Even after adjustments for traditional cardiovascular risk factors, both sRAGE and EN-RAGE were independently associated with cIMT (β=-0.230, p=0.037, β=0.155, p=0.045) and VCS (β=-0.205, p=0.049, β=0.197, p=0.156). Multivariate logistic analysis revealed that old age (OR 1.14, 95% CI 1.03-1.25, p=0.009), presence of diabetes (OR 13.4, 95% CI: 1.20-150.18, p=0.035) and elevated plasma EN-RAGE (OR 2.26, 95% CI: 1.05-5.11, p=0.048) were significant predictors for the occurrence of carotid atherosclerosis (cIMT>1.0mm and/or plaque formation).
  
  
  CONCLUSIONS
  Our findings suggest that elevated plasma EN-RAGE and decreased sRAGE level could play a crucial role in systemic inflammation and carotid atherosclerosis in PD patients.
authors: Department of Internal Medicine & Kidney Research Institute, Hallym University College of Medicine, Anyang, Republic of Korea.
authors: Jwa-Kyung
authors: JK
authors: Kim
authors: Sungha
authors: S
authors: Park
authors: Mi Jung
authors: MJ
authors: Lee
authors: Young Rim
authors: YR
authors: Song
authors: Seung Hyeok
authors: SH
authors: Han
authors: Sung Gyun
authors: SG
authors: Kim
authors: Shin-Wook
authors: SW
authors: Kang
authors: Kyu Hun
authors: KH
authors: Choi
authors: Hyung Jik
authors: HJ
authors: Kim
authors: Tae-Hyun
authors: TH
authors: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000276:immunology; D001027:Aortography; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D009418:S100 Proteins / Q000097:blood*; D000067616:S100A12 Protein; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000276:immunology
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; D009418:S100 Proteins; D000067616:S100A12 Protein; C090441:S100A12 protein, human