背景:阿拉伯联合酋长国正在经历2型糖尿病(T2D)及其并发症的发病率上升。作为晚期糖基化终产物受体的可溶性水平,(sRAGE),和内源性分泌性RAGE(esRAGE),后者是AGER(编码RAGE的基因)的选择性剪接形式,据报道与T2D及其并发症有关,我们在阿联酋受试者中测试了这些因素与T2D状态之间的潜在关系。
方法:在一项病例对照研究中,我们从阿布扎比的SheikhKhalifa医学城招募了阿联酋T2D和对照受试者。拟人化特征,血浆sRAGE和esRAGE的水平,和常规化学变量进行了测量。
结果:两百16名T2D受试者和215名对照受试者(平均年龄,57.4±12.1vs.50.7±15.4年;分别为P<0.0001)。单变量分析表明,T2D中sRAGE的水平显着降低。对照组(1033.9±545.3vs.1169.2±664.1pg/ml,分别为;P=0.02)。多变量分析调整年龄,性别,收缩压,脉搏,身体质量指数,腰围/臀围比,空腹血糖,HDL,LDL,胰岛素,甘油三酯,维生素D和尿素水平显示,T2D和对照受试者之间的sRAGE水平差异仍然具有统计学意义。P=0.03,但在模型中包括估计的肾小球滤过率之后,P=0.14。esRAGE水平无显著差异。血浆胰岛素水平明显高于对照组。T2D受试者(133.6±149.9vs.107.6±93.3pg/L分别;调整年龄和性别后,P=0.01)。
结论:sRAGE的水平,但不是esRAGE,与阿布扎比的T2D状态有关,但不是在eGFR校正后。对照和T2D受试者的血浆胰岛素水平升高表明存在代谢功能障碍,即使在没有糖尿病的受试者中。
BACKGROUND: The United Arab Emirates is experiencing increasing rates of type 2 diabetes (T2D) and its complications. As soluble levels of the receptor for advanced glycation end products, (sRAGE), and endogenous secretory RAGE (esRAGE), the latter an alternatively spliced form of AGER (the gene encoding RAGE), have been reported to be associated with T2D and its complications, we tested for potential relationships between these factors and T2D status in Emirati subjects.
METHODS: In a case-control study, we recruited Emirati subjects with T2D and controls from the Sheikh Khalifa Medical City in Abu Dhabi. Anthropomorphic characteristics, levels of plasma sRAGE and esRAGE, and routine chemistry variables were measured.
RESULTS: Two hundred and sixteen T2D subjects and 215 control subjects (mean age, 57.4 ± 12.1 vs. 50.7 ± 15.4 years; P < 0.0001, respectively) were enrolled. Univariate analyses showed that levels of sRAGE were significantly lower in the T2D vs. control subjects (1033.9 ± 545.3 vs. 1169.2 ± 664.1 pg/ml, respectively; P = 0.02). Multivariate analyses adjusting for age, sex, systolic blood pressure, pulse, body mass index, Waist/Hip circumference ratio, fasting blood glucose, HDL, LDL, insulin, triglycerides, Vitamin D and urea levels revealed that the difference in sRAGE levels between T2D and control subjects remained statistically-significant, P = 0.03, but not after including estimated glomerular filtration rate in the model, P = 0.14. There were no significant differences in levels of esRAGE. Levels of plasma insulin were significantly higher in the control vs. the T2D subjects (133.6 ± 149.9 vs. 107.6 ± 93.3 pg/L. respectively; P = 0.01, after adjustment for age and sex).
CONCLUSIONS: Levels of sRAGE, but not esRAGE, were associated with T2D status in Abu Dhabi, but not after correction for eGFR. Elevated levels of plasma insulin in both control and T2D subjects suggests the presence of metabolic dysfunction, even in subjects without diabetes.