Circulating soluble receptor for advanced glycation end product: Cross-sectional associations with cardiac markers and subclinical vascular disease in older men with and without diabetes

• Published in: Atherosclerosis 2017-09, Vol.264, p.36-43
• Main Authors: Wannamethee, S. Goya, Welsh, Paul, Papacosta, Olia, Ellins, Elizabeth A., Halcox, Julian P.J., Whincup, Peter H., Sattar, Naveed
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Arterial Pressure; Arterial stiffness; Arterial wave reflections; Asymptomatic Diseases; Biomarkers - blood; Blood Glucose - metabolism; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - physiopathology; Carotid Intima-Media Thickness; Cross-Sectional Studies; Diabetes Mellitus - blood; Diabetes Mellitus - diagnosis; Diabetes Mellitus - physiopathology; Glycated Hemoglobin A - metabolism; Humans; Kidney - physiopathology; Male; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Prognosis; Prospective Studies; Pulse Wave Analysis; Receptor for Advanced Glycation End Products - blood; Risk Factors; Sex Factors; Soluble receptor advanced glycation end products; Troponin T - blood; United Kingdom; Up-Regulation; Vascular Stiffness
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2017.07.008

The soluble receptor for advanced glycation end products (sRAGE) has been implicated in diabetic vascular complications. We have examined the association between sRAGE and cardiac markers [NT-proBNP and cardiac troponin T (cTnT)] and subclinical vascular markers in older men with and without diabetes. We performed a cross-sectional study of 1159 men aged 71–92 years with no history of cardiovascular disease (myocardial infarction, stroke, heart failure, coronary artery bypass graft operation or angioplasty). Prevalent diabetes included men with a doctor diagnosis of diabetes, men with fasting glucose ≥7 mmol/l or HbA1c ≥ 6.5% (N = 180). Subclinical vascular measurements included carotid intima media thickness (cIMT), arterial stiffness [pulse wave velocity (PWV)], central aortic blood pressure and arterial wave reflections [central augmentation pressure (AP) and augmentation index (AIx)]. sRAGE was strongly and positively associated with renal dysfunction in men with and without diabetes. sRAGE was significantly and positively associated with NT-proBNP (but not cTnT) and AP and AIx in both groups of men after adjustment for CVD risk and metabolic risk markers, renal function and inflammation. However, no association was seen between sRAGE and central aortic blood pressure, cIMT or arterial stiffness as determined by PWV in either group. Higher plasma sRAGE was associated with increased NT-proBNP and markers of arterial wave reflections in men both with and without diabetes. Increased sRAGE may contribute to or be a marker of worsening cardiac dysfunction or HF. Further studies with cardiac imaging data are required to confirm this. •In men with no diagnosed CVD, sRAGE is associated with the cardiac marker NT-proBNP.•sRAGE also related positively to markers of arterial wave reflection.•These associations were present in both men with and without diabetes.•Whether sRAGE predicts worsening cardiac dysfunction and heart failure needs testing.