Published online May 26, 2021. doi: 10.4330/wjc.v13.i5.130
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.
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.