Abstract 14065: Receptor for Advanced Glycation End-products (RAGE) and CAC Progression in Adults with Type 1 Diabetes
Advanced glycation end-products (AGEs) result from poor glycemic control and are associated with cardiovascular disease (CVD) in patients with diabetes. A soluble form of the receptor for AGEs (sRAGE) is a competitive inhibitor to AGEs and appears to decrease CVD complications in animal models. The objective of this study was to evaluate whether there is an association between sRAGE and progression of coronary artery calcium (CAC), a marker of subclinical atherosclerosis, in adults with type 1 diabetes (T1D).
There were 413 adults (219 female and 194 male, age 39.6±9 years, diabetes duration 25.5±9 years) from the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study who had plasma sRAGE measured at the first follow-up study examination and who completed a second follow-up study visit 3 years later. CAC was measured in duplicate and averaged at each visit, and CAC progression was defined as an increase ≥ 2.5 in square root transformed CAC volume.
One hundred forty two participants (34%) had CAC progression. Plasma sRAGE was significantly lower in subjects with CAC progression compared to non-progressors (1368±670 pg/mL and 1545±557 pg/mL, respectively p=0.0069). Logistic regression analysis (Table) showed each SD increase in unadjusted sRAGE predicted reduced odds of CAC progression. This association remained significant when adjusted for age and sex, but not when additionally adjusted for diabetes duration and then baseline CAC volume. Adjusting for hemoglobin A1c (HbA1c), higher sRAGE was associated with reduced odds of CAC progression where HbA1c ≤ 7.5%, but there was no association of sRAGE and CAC progression where HbA1c was ≥ 8%.
These results suggest that higher plasma sRAGE predict reduced subclinical atherosclerosis among T1D patients with good glycemic control (HbA1c ≤ 7.5%).
- © 2011 by American Heart Association, Inc.