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

Affiliations
  • 1Department of Neurology, Wonkwang University School of Medicine, Iksan, Korea.
  • 2Department of Cardiovascular Medicine, Wonkwang University School of Medicine, Iksan, Korea.
  • 3Department of Laboratory Medicine, Wonkwang University School of Medicine, Iksan, Korea. email@wku.ac.kr
  • 4Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

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.

  • 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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