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

摘要

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±3.4years. 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 5years, 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±451.0pg/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±0.14mm) ( 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.