Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. May 26, 2021; 13(5): 130-143
Published online May 26, 2021. doi: 10.4330/wjc.v13.i5.130
Correlation between soluble receptor for advanced glycation end products levels and coronary artery disease in postmenopausal nondiabetic women
Soumitra Ghosh, Divya Kapoor, Rajesh Vijayvergiya, Sonal Sangwan, Sujata Wangkheimayum, Sakshi Mehta, Veena Dhawan
Soumitra Ghosh, Rajesh Vijayvergiya, Department ofCardiology, PGIMER, Chandigarh 160012, India
Divya Kapoor, Sonal Sangwan, Sakshi Mehta, Veena Dhawan, Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh 160012, India
Sujata Wangkheimayum, Department of Biochemistry, PGIMER, Chandigarh 160012, India
Author contributions: Ghosh S designed the research along with collection of samples and analysis; Kapoor D helped in analysis and writing of manuscript; Sangwan S performed the experiments; Study was conducted under the direct supervision of Vijayvergiya R, Wangkheimayum S and Dhawan V; Mehta S and Dhawan V edited and revised the manuscript.
Institutional review board statement: Ethical approval for the study was obtained from the Institute Ethics Committee of the PGIMER, Chandigarh, India, No. INT/IEC/2016/2134.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Veena Dhawan, PhD, Professor, Department of Experimental Medicine and Biotechnology, PGIMER, Sector-12, Chandigarh 160012, India.
Received: January 9, 2021
Peer-review started: January 9, 2021
First decision: February 28, 2021
Revised: March 4, 2021
Accepted: April 28, 2021
Article in press: April 28, 2021
Published online: May 26, 2021

The established cardiovascular risk factors cannot explain the overall risk of coronary artery disease (CAD), especially in women. Therefore, there is a growing need for the assessment of novel biomarkers to identify women at risk. The receptor for advanced glycation end products (RAGE) and its interaction with the advanced glycation end product (AGE) ligand have been associated with atherogenesis. The soluble fraction of RAGE (sRAGE) antagonizes RAGE signaling and exerts an antiatherogenic effect.


The study aim was to explore the association between plasma levels of sRAGE and CAD in nondiabetic postmenopausal women.


This case-control study included 110 nondiabetic postmenopausal women who were enrolled in two groups. Group I included 55 angiographically proven CAD subjects with > 50% stenosis in at least one of the major coronary arteries and Group II included 55 healthy control women who did not have CAD or had < 50% stenosis of the coronary arteries. Stenosis was confirmed by invasive angiography. Plasma sRAGE was determined by an enzyme-linked immunosorbent assay.


We observed significantly lower plasma sRAGE concentrations in subjects with CAD vs healthy controls (P < 0.05). Univariate and multivariate logistic regression analysis also revealed a significant correlation between plasma sRAGE levels and CAD (P = 0.01). Multivariate odds ratios for CAD revealed that subjects with sRAGE concentrations below 225 pg/mL (lowest quartile) had a 6-fold increase in CAD prevalence independent of other risk factors.


Our findings indicated that low sRAGE levels were independently associated with CAD in nondiabetic postmenopausal women. Risk assessment of CAD in postmenopausal women can be improved by including sRAGE along with other risk factors.

Keywords: Coronary artery disease, Soluble receptor for advanced glycation end products, Postmenopausal status, Nondiabetic females, Correlation, Regression

Core Tip: The growing need for the assessment of novel biomarkers led us to identify the risk in women. The receptor for advanced glycation end products (RAGE) and its interaction with the AGE ligand have been shown to play an important role in promoting atherosclerosis. The soluble fraction of RAGE (sRAGE) binds to ligands and antagonizes RAGE signaling, thereby exerting an antiatherogenic effect. This study established that low levels of sRAGE in plasma are independently associated with the presence of coronary artery disease in nondiabetic postmenopausal females.