Soluble receptor for advanced glycation end products in critically ill patients and its associations with other clinical markers and 28-day mortality

Abstract

PurposeTo investigate the possible associations between serum levels of soluble receptor for advanced glycation end products (sRAGE) and specific clinical markers and prognosis in critically ill patients diagnosed with stress hyperglycemia.Patients and methodsA total of 70 critically ill patients and 25 normal controls were recruited for this study. Serum levels of sRAGE and advanced glycation end products (AGEs) were determined using enzyme-linked immunosorbent assay. Additional data on other clinical markers were obtained from patient records in the intensive care unit. Comparisons of sRAGE and AGEs levels between groups were assessed by t-test. The relationships between sRAGE and other clinical markers were assessed by Pearson’s correlation analyses and multiple linear regression analyses. Risk factors for prognosis, such as 28-day mortality were analyzed using logistic regression analysis.ResultsSerum sRAGE and AGEs levels were significantly higher in critically ill patients, compared to normal controls (P<0.05). The increase in serum sRAGE levels was significantly correlated with AGEs levels, interleukin-6 levels, and the sequential organ failure assessment score (P<0.01). Using multiple linear regression analysis, the association between AGEs and sRAGE remained significant after adjustment of other clinical factors. However, there were no significant correlations between sRAGE levels and patient outcome in these critically ill patients.ConclusionSerum sRAGE levels were significantly elevated in critically ill patients and positively correlated with higher AGEs levels, but sRAGE levels were not associated with increased mortality, suggesting sRAGE levels are not a predictor of prognosis in critically ill patients.

Diabetes-Specific Formulae Versus Standard Formulae as Enteral Nutrition to Treat Hyperglycemia in Critically Ill Patients: Protocol for a Randomized Controlled Feasibility Trial

“…Blood glucose control including insulin/oral hypoglycemic use pre and post ICU admission will also be explored. The planned sub-study aims to analyze blood and urine samples to establish differences in acute and chronic inflammatory markers, cortisol, oxidative stress and anti-oxidant capacity between baseline and 48 hours later while on differing nutritional products [48][49][50][51][52][53]. Blood samples will be retrieved through existing arterial lines, centrifuged within 45 minutes and stored at negative eighty degrees Celsius until batch analysis.…”

The impact of a modified carbohydrate formula, and its constituents, on glycaemic control and inflammatory markers: A nested mechanistic sub‐study

“…8,9 Despite this, increased circulating sRAGE concentrations are consistently associated with inflammation, specifically elevations in interleukin (IL)-6. [10][11][12] It remains to be determined, however, whether sRAGE and inflammation are directly affected by exogenously administered nutrition formulae during hospitalisation in a critical care context.…”

“…The effects of RAGE binding are opposed by the actions of circulating soluble RAGE (sRAGE), which is a competitive decoy receptor for cellular RAGE acting to dampen inflammation 8,9 . Despite this, increased circulating sRAGE concentrations are consistently associated with inflammation, specifically elevations in interleukin (IL)‐6 10–12 . It remains to be determined, however, whether sRAGE and inflammation are directly affected by exogenously administered nutrition formulae during hospitalisation in a critical care context.…”