Korean Circ J.  2012 May;42(5):335-340. 10.4070/kcj.2012.42.5.335.

High Serum Advanced Glycation End-Products Predict Coronary Artery Disease Irrespective of Arterial Stiffness in Diabetic Patients

• Won KB
• Chang HJ
• Park SH
• Hong SY
• Jang Y
• Chung N

• KMID: 2028762
• DOI: http://doi.org/10.4070/kcj.2012.42.5.335

Abstract

BACKGROUND AND OBJECTIVES
Advanced glycation end-products (AGEs) contribute to the development of atherosclerosis. We investigated whether serum AGEs are related to the presence or severity of coronary artery disease (CAD), and explored the association between serum AGEs and arterial stiffness according to diabetes status in patients suspected of having CAD.
SUBJECTS AND METHODS
The measurement of serum AGEs and brachial-ankle pulse wave velocity (baPWV) were performed in 145 consecutive patients (63+/-9 years, 58% men) who received a coronary angiogram for evaluation of CAD.
RESULTS
Forty-four diabetics and 101 non-diabetics were classified into three subgroups based on the number of diseased vessels with obstructive CAD: 0, 1, and 2 or more vessel diseases (VDs). Serum AGEs were significantly higher in diabetics with obstructive CAD than in those without obstructive CAD (2.16+/-0.29 vs. 1.85+/-0.29 mU/mL, p=0.010) and were significantly correlated with the number of VDs only in diabetics (r=0.504, p<0.001). Serum AGEs were not significantly correlated with baPWV in diabetics or non-diabetics. In receiver operating characteristics analysis, the cut-off value of serum AGEs as a predictor of obstructive CAD was 1.98 mU/mL, with 64% sensitivity and 63% specificity in diabetics. In multiple regression analysis, serum AGEs independently predicted obstructive CAD and were associated with the number of VDs in diabetics.
CONCLUSION
Serum AGEs independently predict obstructive CAD and the severity of coronary atherosclerosis irrespective of arterial stiffness only in diabetics. Evaluation of PWV and serum AGEs together may be more effective to identify the risk of CAD in diabetic individuals.

Keyword

Advanced glycation end-products; Coronary artery disease; Pulse wave velocity; Diabetes mellitus

MeSH Terms

Atherosclerosis
Coronary Artery Disease
Coronary Vessels
Diabetes Mellitus
Glycosaminoglycans
Humans
Pulse Wave Analysis
ROC Curve
Sensitivity and Specificity
Vascular Stiffness
Glycosaminoglycans

Figure

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  Fig. 1 Comparison of serum levels of AGEs with and without obstructive CAD in diabetic patients. *p=0.010. AGEs: advanced glycation end-products, CAD: coronary artery disease.

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  Fig. 2 Receiver operating characteristics curve of serum levels of AGEs for obstructive CAD in diabetic patients. AUC=0.747; 95% CI 0.576 to 0.917; p=0.031. The cut-off point for levels of AGEs using the Youdean index was 1.98 mU/mL (sensitivity=0.639, specificity=0.625). AGEs: advanced glycation end-products, CAD: coronary artery disease. AUC: area under the curve, CI: confidence interval.

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  Fig. 3 Correlation between serum levels of AGEs and the number of diseased vessels with obstructive coronary artery disease in diabetes patients. r=0.504; p<0.001. AGEs: advanced glycation end-products.

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