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Reduced endogenous secretory receptor for advanced glycation end products (esRAGE) in young people with Type 1 diabetes developing microalbuminuria
Author(s) -
Marcovecchio M. L.,
Giannini C.,
Dalton R. N.,
Widmer B.,
Chiarelli F.,
Dunger D. B.
Publication year - 2009
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2009.02761.x
Subject(s) - medicine , microalbuminuria , glycation , endocrinology , confidence interval , diabetes mellitus , body mass index , type 1 diabetes , type 2 diabetes , prospective cohort study
Aims The endogenous secretory receptor for advanced glycation end products (esRAGE) appears to work as a scavenger for AGEs and it has been implicated in the pathogenesis of diabetic complications. The aim of the present study was to perform a longitudinal evaluation of esRAGE in young people with Type 1 diabetes (T1D) in relation to the development of microalbuminuria (MA). Methods Serum esRAGE levels were measured in longitudinally collected blood samples from 49 T1D patients with MA (MA+) and 49 matched normoalbuminuric patients (MA−), followed in the Oxford Regional Prospective Study. esRAGE levels were compared between MA+ and MA− subjects in relation to the time of MA onset. Results Overall, esRAGE levels were significantly lower in MA+ than in MA− subjects (0.727 ± 0.396 vs. 0.936 ± 0.433 ng/ml; P = 0.015). These differences between the two groups were present both before (0.725 ± 0.410 vs. 0.956 ± 0.505 ng/ml, P = 0.038) and after the onset of MA (0.750 ± 0.433 vs. 0.948 ± 0.418 ng/ml, P = 0.04). In a longitudinal analysis there was no effect of age, duration, glycated haemoglobin (HbA 1c ) or body mass index standard deviation scores on esRAGE levels (all P > 0.05). In a Cox model, esRAGE levels significantly contributed to the probability of developing MA [Exp(B)(95% confidence interval): 0.34(0.12–0.98); P = 0.04), independently of HbA 1c . Conclusions In this longitudinal study of young people with T1D, esRAGE levels were reduced in MA+ subjects, even before the onset of MA, and appeared to be related to its development, thus suggesting a potential role of esRAGE in the pathogenesis of this complication.