Ⅲ~Ⅴ期糖尿病肾病患者血清 sRAGE、esRAGE、cRAGE 水平与冠状动脉钙化的关系

Serum sRAGE,esRAGE,cRAGE levels and coronary artery calcification in patients with stageⅢ-Ⅴdiabetic nephropathy

目的:通过检测糖尿病肾病患者血清可溶性晚期糖基化终末产物受体(sRAGE)、内源性分泌型晚期糖基化终末产物受体(esRAGE)、裂解型晚期糖基化终末产物受体(cRAGE),探讨其与冠状动脉钙化严重程度的相关性。方法:选取2017年2月~2019年6月住院的糖尿病肾病患者53例,其中Ⅲ期18例,Ⅳ期17例,Ⅴ期18例。检测患者血清sRAGE、esRAGE、cRAGE水平,并评估其与冠状动脉钙化严重程度的相关性。结果:Ⅳ和Ⅴ期糖尿病肾病患者血清sRAGE、esRAGE和cRAGE水平均高于Ⅲ期患者(P<0.05),Ⅴ期糖尿病肾病患者sRAGE、esRAGE和cRAGE和冠状动脉钙化积分(CACS)水平亦高于Ⅳ期患者(P<0.05)。糖尿病肾病患者血清sRAGE(r=0.961)、esRAGE(r=0.931)、cRAGE(r=0.964)水平与CACS均呈正相关(P<0.05)。结论:早期联合检测sRAGE、esRAGE、cRAGE可能成为评估糖尿病肾病患者病情严重程度的重要指标之一,也是预测其发生冠状动脉疾病等心血管事件的重要指标之一。

Objective:To investigate the association of serum soluble advanced glycation end product receptor(sRAGE),endogenous secretory advanced glycation end product receptor(esRAGE)and cleavage advanced glycation end product receptor(cRAGE)with the severity of coronary artery calcification in patients with diabetic nephropathy.Methods:A total of 53 diabetic nephropathy patients,including 18 at stageⅢ,17 at stageⅣ,and 18 at stageⅤ,admitted to our hospital were enrolled from February 2017 to June 2019.Serum levels of sRAGE,esRAGE and cRAGE were measured in all patients,and evaluated for the association with the severity of coronary artery calcification.Results:Serum sRAGE,esRAGE and cRAGE levels were higher in patients at stageⅣandⅤdiabetic nephropathy than in those at stageⅢ(P<0.05),and level sRAGE,esRAGE,cRAGE and coronary artery calcification score(CACS)were higher in patients at stageⅤthan those at stageⅣ(P<0.05).Serum levels of sRAGE(r=0.961),esRAGE(r=0.931)and cRAGE(r=0.964)were positively correlated with CACS in diabetic nephropathy patients(P<0.05).Conclusion:Early detected sRAGE,esRAGE and cRAGE levels may serve as important indicators for assessing the severity of diabetic nephropathy,and those indicators are also helpful in predicting cardiovascular events such as coronary artery disease.