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Med. Sci. 2018, 6(2), 38; https://doi.org/10.3390/medsci6020038

Critical Appraisal of Advanced Glycation End Products (AGEs) and Circulating Soluble Receptors for Advanced Glycation End Products (sRAGE) as a Predictive Biomarkers for Cardiovascular Disease in Hemodialysis Patients

1
Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makah 21955, Saudi Arabia
2
Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
3
Medical Biochemistry Department, Faculty of Medicine, Menoufia University, Shebin Al-Kom 32511, Egypt
*
Author to whom correspondence should be addressed.
Received: 8 April 2018 / Revised: 5 May 2018 / Accepted: 15 May 2018 / Published: 22 May 2018
(This article belongs to the Section Cardiovascular Disease)
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Abstract

The interaction of advanced glycation end products (AGE) and their receptors promote vascular complications of diabetes in hemodialysis (HD) patients. The soluble form of the receptor for the advanced glycation end-products (sRAGE) has been studied as a vascular biomarker in various diseases with controversial results. Our aim was to evaluate the association of the serum levels of the AGEs and their receptor sRAGE with cardiovascular disease (CVD) and the cardiovascular risk factors among HD patients. There were 130 HD patients and 80 age and gender matched control subjects were involved; 31.5% of the HD group were diabetic, which was an underlying cause of renal impairment; 36.1% had CVD, which was comprising 44.7% of diabetics and 55.3% of non-diabetic patients. The AGEs and sRAGE were assessed by enzyme linked immunosorbent assay (ELISA). In addition, the lipid profile, glycemic indices, pre-dialysis renal function tests, and hemoglobin % (Hb) were evaluated. The results show that the circulating AGEs and sRAGE levels were significantly higher in the HD patients. Those with underlying diabetes displayed higher sRAGE levels, which were positively correlated with hyperglycemia, HbA1C, and total cholesterol (TC). The HD patients with an increased serum sRAGE exhibited more cardiovascular risk factors (hypercholesterolemia and anemia) with a high prevalence of CVD. Using a linear regression analysis, we found a significant association of sRAGE with CVD and TC among HD patients, regardless of whether associating diabetes was an underlying cause of renal impairment. Overall, the HD patients displayed significantly higher serum AGEs with a concomitant increase in the circulating sRAGE levels, mainly in the diabetic HD, which were significantly associated with the CVD (independent predictors) and CV risk factors (hypercholesterolemia), mainly sRAGEs, regardless of the underlying diabetes mellitus. This highlights the prognostic role of AGEs and sRAGE in HD patients regardless of underlying cause in order to predict the risk for CVD. View Full-Text
Keywords: advanced glycation end products; soluble receptor advanced glycation end products; chronic kidney diseases; cardiovascular diseases; diabetes mellitus advanced glycation end products; soluble receptor advanced glycation end products; chronic kidney diseases; cardiovascular diseases; diabetes mellitus
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Assiri, A.M.A.; Kamel, H.F.M.; ALrefai, A.A. Critical Appraisal of Advanced Glycation End Products (AGEs) and Circulating Soluble Receptors for Advanced Glycation End Products (sRAGE) as a Predictive Biomarkers for Cardiovascular Disease in Hemodialysis Patients. Med. Sci. 2018, 6, 38.

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