J Clin Neurol.  2009 Sep;5(3):126-132. 10.3988/jcn.2009.5.3.126.

Levels of Soluble Receptor for Advanced Glycation End Products in Acute Ischemic Stroke without a Source of Cardioembolism

• Park HY
• Yun KH
• Park DS

• KMID: 2045418
• DOI: http://doi.org/10.3988/jcn.2009.5.3.126

Abstract

BACKGROUND AND PURPOSE
Low levels of soluble receptor for advanced glycation end products (sRAGE) are associated with three conventional vascular risk factors (3Fs: diabetes, hypertension, and hypercholesterolemia), nondiabetic coronary artery disease, and Alzheimer's disease. However, the association between sRAGE and acute ischemic stroke (AS), especially AS without a source of cardioembolism, has not yet been established. Methods: Patients with AS without a source of cardioembolism (n=259) and age-matched controls (n=300) were grouped according to the presence of 3Fs: AS patients with and without 3Fs (3Fs+ AS and 3Fs- AS, respectively) and controls with and without 3Fs (3Fs+ control and 3Fs- control, respectively). Levels of sRAGE were analyzed among the four groups. RESULTS: sRAGE was significantly higher in the controls than in the AS patients (855 pg/mL vs. 690 pg/mL, p<0.01). sRAGE was significantly higher in 3Fs- controls (996 pg/mL, p<0.05) than in 3Fs+ controls (721 pg/mL), and in AS group regardless of the 3Fs (629 pg/mL in 3Fs- and 705 pg/mL in 3Fs+). The lowest tertile of sRAGE was associated with an increased risk of AS in the 3Fs- group [adjusted odds ratio (OR) 4.0, 95% confidence interval (CI) 1.6-10.3, p<0.01] but not in the 3Fs+ group. The level of sRAGE was also correlated with neurological severity in the 3Fs- AS group (r=-0.32, p<0.05) but not in the 3Fs+ AS group. CONCLUSIONS: Low plasma levels of sRAGE is a potential biomarker for the risk of AS and may reflect the neurological severity of the condition, especially in subjects without identifiable conventional risk factors.

Keyword

stroke; soluble receptor for advanced glycation end products; diabetes; hypertension; hypercholesterolemia

MeSH Terms

Alzheimer Disease
Coronary Artery Disease
Glycosylation End Products, Advanced
Humans
Hypercholesterolemia
Hypertension
Odds Ratio
Plasma
Risk Factors
Stroke
Glycosylation End Products, Advanced

Figure

• 

  Fig. 1 Comparison of soluble receptor for advanced glycation end products (sRAGE) levels according to the presence of acute ischemic stroke (AS)(A) or any of the three sRAGE-related vascular risk factors (3Fs)(B): diabetes, hypertension, and hypercholesterolemia. Data are mean and 95% confidence interval values. *t-test, †ANOVA test followed by a Scheffe post-hoc test. ns: not significant.

• 

  Fig. 2 Numbers of subjects across tertiles of sRAGE levels in controls (white bars) and AS patients (gray bars). sRAGE: soluble receptor for advanced glycation end products, AS: acute ischemic stroke.

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  Fig. 3 Association between tertiles of sRAGE and risk of AS according to the presence of any of the 3Fs (A: 3Fs positive and negative group. B: 3Fs negative group. C: 3Fs positive group). The odds ratio was adjusted for age (in years), sex, 3Fs, current smoking, hyper-low-density lipoprotein cholesterolemia, hypo-high-density lipoprotein cholesterolemia, and hypertriglyceridemia. sRAGE: soluble receptor for advanced glycation end products, AS: acute ischemic stroke.

• 

  Fig. 4 Correlations between plasma sRAGE and carotid intimal-medial thickness (A) or National Institutes of Health Stroke Scale (NIHSS) score (B) according to the presence of any of the 3Fs in AS. sRAGE: soluble receptor for advanced glycation end products, AS: acute ischemic stroke.

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