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Assessment of serum ɛN-carboxymethyllysine and soluble receptor of advanced glycation end product levels among type 2 diabetes mellitus patients with and without acute coronary syndrome

Shanija S, Prashant Shankarrao Adole, Kolar Vishwanath Vinod, Rama Prakasha Saya.

Background: One of the most predominant macrovascular complications of type 2 diabetes mellitus (T2DM) is acute coronary syndrome (ACS). Advanced glycation end products (AGEs) play an important role in the development and progression of ACS in T2DM patients. The soluble receptor of AGEs (sRAGE) decoys the effect of AGEs by binding with them.

Objectives: The objectives of the study were to measure serum ɛN-carboxymethyllysine (CML) and sRAGE levels among T2DM with and without ACS and to find out whether serum CML and sRAGE could be used to predict the risk of ACS among T2DM patients.

Materials and Methods: A total of 37 T2DM patients with ACS were selected as cases and 37 T2DM as controls. Routine biochemical parameters were carried out on autoanalyzer and serum CML and sRAGE were estimated by ELISA. The data were recorded and analyzed on SPSS system and were compared by Student’s t-test or Mann–Whitney test.

Results: Serum CML level and CML/sRAGE ratio were significantly increased in the cases as compared to control. Correlation analyses showed that serum CML concentration and serum CML/sRAGE ratio were positively correlated with weight, waist circumference, body mass index and serum urea, and very low-density lipoprotein-cholesterol. Multivariate regression (Binary logistics) analysis after adjusted for waist circumference, weight, BMI, and systolic blood pressure showed that serum CML was significantly associated with ACS risk among T2DM patients. Receiver operating characteristic curve depicted that high CML level (>31.83 ng/ml) and CML/sRAGE ratio (>15.48) were associated with greatest risk of ACS among type 2 DM patients.

Conclusion: T2DM patients with high serum CML concentration and CML/sRAGE ratio were at risk of ACS independent of other cardiovascular risks.

Key words: Type 2 Diabetes Mellitus; Acute Coronary Syndrome; ɛN-carboxymethyllysine; Soluble Receptor of Advanced Glycation End Product

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