Soluble receptor for advanced glycation end products (sRAGE) and carotid intima-media thickness (CIMT) in type 1 diabetes Mellitus: Possible association with diabetic vascular complications

Abstract

Background: Advanced glycation end products (AGEs) are a heterogeneous and complex group of biochemical compounds, resulting from nonenzymatic glycation and oxidation of protein, nucleic acids, and lipids. Aim of the study: To assess sRAGE and CIMT in patients with T1DM and their relation to glycemic control and diabetic vascular complications. Patients & methods: This study included 60 patients with mean age of 14.4 ± 3.4 years. They were subdivided into complicated and non complicated groups according to the presence of microvascular complications. Thirty age and sex matched controls were included. Patients with disease duration less than 5 years, connective tissue disease, liver dysfunction, or apparent cardiovascular disease and those on lipid lowering agents were excluded. Laboratory investigations included; HbA1c%, urinary albumin excretion (UAE), fasting lipid profile and sRAGE. Mean CIMT was measured by dopplex ultrasound. Results: Patients had higher sRAGE (1765.0 ± 451.0 pg/ml) (p < 0.001) especially the non complicated group (p = 0.18). It was directly correlated to HDL (r = 0.3, p = 0.012). Patients had increased CIMT (0.57 ± 0.14 mm) (p < 0.001) with 13.3% having carotid wall abnormalities. CIMT was directly correlated to age, weight, BMI, systolic and diastolic blood pressures, UAE, cholesterol and LDL (p < 0.05) and inversely correlated to HDL (p < 0.05). Neither CIMT nor sRAGE were correlated to glycemic control or disease duration. Conclusion: Patients with T1DM are at risk of increased CIMT with a concomitant increase in sRAGE which may be a therapeutic target for the prevention of diabetic vascular complications.

Keywords

• Type 1 diabetes mellitus
• CIMT
• sRAGE
• Vasculopathy