Correlation Between The Ratio Of AGEs To SRAGE And Coronary Artery Calcification

Objective:Advanced glycosylation endproducts through its receptor and other signals play an important role in the calcification of blood vessels.As a bait receptor,the sRAGE can reduce vascular calcification by competitively binding to AGEs with RAGE,thereby reducing AGEs/RAGE signals and other signal activation.The correlation between AGEs level?sRAGE level?the ratio of AGEs to sRAGE and coronary artery calcification was explored by detecting AGEs and sRAGE levels in the serum of the target population.Methods:1.Subjects: patients with coronary CTA who were hospitalized in the department of cardiology,affiliated hospital of jiujiang university from October,2011 to October,2010.(1)Inclusion criteria: Multislice spiral CT(MSCT)coronary angiography was needed,aged 18 to 85 years,clear consciousness,clear speech,and no history of mental illness.(2)exclusion criteria: Alzheimer's disease or vascular dementia;Previous history of angina pectoris or myocardial infarction or severe arrhythmia or coronary artery stent implantation or coronary artery bypass grafting;Hyperthyroidism without control;The patient has other serious diseases(such as cancer,respiratory failure,renal failure);Information is not complete.2.Study grouping: 62 patients who had undergone MSCT coronary angiography were grouped according to coronary artery calcification score(CACS),of which 41 patients were in the coronary artery calcification group(CAC group)and 21 patients were in the normal control group(CON group).3.Methods: special computer software(Agatston score)was used to calculate the CACS of each research object.The serum AGEs and sRAGE levels were detected by ELISA,and the ratio of AGEs to sRAGE was calculated.Spearman rank correlation analysis was used to analyze the correlation between CACS and AGEs,sRAGE levels and AGEs/sRAGE ratios through SPSS 20.0 software,and ROC curve was used to predict the diagnostic value of AGEs,sRAGE and the ratio of AGEs to sRAGE for CAC.Results:1.There was no statistical difference between the CAC group and control group in age,BMI,hypertension and smoking history(P>0.05).The age of the CAC group was 60.9 to 11.5 years,and the age of the control group was 58.3 to 10.8(P=0.371).The BMI in the CAC group was 23.6 to 3.9,and the BMI in the control group was 22.8 to 3.6(P=0.326).The proportion of hypertension in the CAC group was 22%,and the proportion of hypertension in control group was 19%(P=0.543).The proportion of smoking history in the CAC group was 26.8%,and the proportion of smoking history in the control group was 23.8%(P=0.267).The differences between CAC group and control group in terms of gender composition and the number of people with hyperlipidemia and diabetes were statistically significant(P <0.05).The share of men in the CAC group was 63.4% and that of women was 36.6%,while the proportion of men in the control group was 71.4% and the proportion of women was 28.6%(P=0.029).The proportion of hyperlipidemia in the CAC group was 48.8%,and the proportion of hyperlipidemia in control group was 28.6%(P=0.021).The proportion of diabetics in the CAC group was 36.6%,and the proportion of diabetics in control group was 19%(P=0.032).2.The average concentration of serum AGEs was 38.55± 3.30 ng/ml,the average concentration of serum sRAGE was 33.38±3.78 ng/m,and the average ratio of AGEs to sRAGE was 1.15±0.18 in the control group.The average concentration of serum AGEs was 65.27±6.95 ng/ml,the average concentration of sRAGE was 26.91± 4.07 ng/m,and the average ratio of AGEs to sRAGE was 2.04 ± 0.51 in the CAC group.The AGEs level and the ratio of AGEs to sRAGE in the CAC group were higher than those in the control group,and the difference was statistically significant(P <0.05).The serum sRAGE level in the CAC group was lower than that of the control group,and the difference was statistically significant(P <0.05).3.The concentration of serum AGEs is positively correlated with CACS scores with a correlation coefficient of 0.737.The ratio of AGEs to sRAGE is positively correlated with CACS scores,and the correlation coefficient is 0.821,while sRAGE and CACS scores are negatively correlated with a correlation coefficient of-0.359.4.The ROC curve AUC of Serum AGEs diagnosis CAC is 0.821(P< 0.001),95% CI is 0.643 to 0.883,indicating that serum AGEs have a moderate diagnostic value for CAC,and the critical value of serum AGEs diagnostic CAC is 45.82 ng/ml,the corresponding diagnostic sensitivity is 65.9% and the specificity is 90.5%.The ROC curve AUC of the ratio of AGEs to sRAGE diagnosis CAC is 0.904(P <0.001),95% CI is 0.825 to 0.982,indicating that the ratio of AGEs to sRAGE has a higher diagnostic value for CAC,the critical value of serum AGEs/sRAGE ratio diagnostic CAC is 1.5652,corresponding diagnostic sensitivity is 78.0%,and specificity is 90.5%.The ROC curve AUC of Serum sRAGE diagnosis CAC is 0.805(P 0.001),95% CI is 0.690 to 0.919,indicating that serum sRAGE has a moderate diagnostic value for CAC,and the critical value of serum sRAGE diagnostic CAC is 37.23 ng/ml,the corresponding diagnostic sensitivity is 90.5% and the specificity is 64.3%.Conclusions:Serum sRAGE level is negatively correlated with the development of CAC,and sRAGE level has medium diagnostic value for CAC.Serum AGEs level and AGEs/sRAGE ratio were positively correlated with the development of CAC,AGEs levels had medium diagnostic value for CAC,and the ratio of AGEs to sRAGE have high diagnostic value for CAC.The ratio is expected to be a convenient indicator for evaluate CAC that will help identify people who at the risk of cardiovascular disease and prevent cardiovascular events.