Tip 2 Diyabetik Hastalarda Serumda Gelişmiş Glikasyon Ürünlerin Çözünür Reseptörü (Srage) Seviyesiyle Sol Ventrikül Diyastolik Disfonksiyonun İlişkisi

Abstract

The binding of advanced glycation end products (AGEs) to their receptor (RAGE) plays an important role in the development of diabetic cardiovascular complications. RAGE has a circulatingsecretory receptor form soluble RAGE (sRAGE), which by neutralizing the action of advanced glycation end products, might exert a protective role against the development of cardiovascular disease. The aim of this study, first, is to evaluate the relationship betweenserum sRAGE levelsand diyastolik dysfunction in patients with type 2 diabetes aged between 18-50 years, second is to find out whether sRAGE levels can be an effective biomarker that can predict an early cardiovascular complications in type 2 diabetic patients without any previous complications. 40 patients 18-50 years age with type 2 diabetes without any cardiovascular risk was inroled in this study, with 40 healthy control group. The median age of both gruops was close to eachother (Type 2 DM 43.28±7.9, Control 41.05±8.5, p>0.233). The serum sRAGE level in type 2 diabetic patiens was significantly lower than in healthy control group(Type2 DM 676.74±128.2vs, Control 1044.88±344.6, p<0.05). Diastolic dysfunction was observed in 50% of type 2 diabetec patients, of these 40% grad 1 and 10% had grad 2 diastolic dysfunction. In multivariant regretion analysis serum sRAGE level and E/A ratio were independent predictives of diastolic dysfunction in type 2 diabetic patients. Cutoff value that makes these parameters significant were respectively (sRAGE ?642.628 pg/ml with 60%sensitivity& 100%specifity) , and (E/A Ratio ?0,79 with 80%sensitivity&100%specifity). When multivariant regretion analysis was done the level of serum sRAGE was inversely associated with diabetic duration. Lateral E? anddiabetic duration were significant independent predictors taht affect serum sRAGE levels in type 2 diabetic patients. In conclusion, our study showed that serum sRAGE level was significantly lower in type 2 diabetic patients, is inversly associated with duration of diabetes, and may act as an important biomarker that predicts diastolic dysfunction in type 2 diabetic patients.