Association of RAGE with acute ischemic stroke prognosis in type 2 diabetes
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ORIGINAL ARTICLE
Association of RAGE with acute ischemic stroke prognosis in type 2 diabetes Bin Liu 1 & Xinchun Ye 2 & Guifeng Zhao 3 & Ling Jin 1 & Jingping Shi 4 Received: 30 July 2019 / Accepted: 23 September 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background In experimental models, the receptor for advanced glycation end products (RAGE) has been reported as a key mediator in cerebral ischemia. In this study, the clinical significance of serum RAGE levels in acute ischemic stroke patients with type 2 diabetes was determined. Method Three hundred seven patients (165 patients without diabetes and 142 patients with diabetes) with acute cerebral infarction (ACI) were enrolled over 3 consecutive months. On admission, their National Institute of Health Stroke Scale (NIHSS) scores were recorded. The clinical laboratory data of all subjects were collected, and their serum levels of RAGE were assayed using enzyme-linked immunosorbent assay (ELISA). On admission and 3 months after stroke, the clinical outcomes were assessed using the Barthel index (BI) and modified Rankin scale (mRS). Results Patients with diabetes (PwD) had significantly higher levels of triglycerides (TGs), RAGE, fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c), and worse stroke prognosis than patients without diabetes (p < 0.05). Hypertension history, RAGE, and FBG in patients without diabetes in ischemic stroke were increased, relative to stroke prognosis. Weight, RAGE, and FBG data showed significant correlation with stroke outcome in PwD (p < 0.05). Multiple logistic regression analysis indicated that the RAGE level was an independent risk factor for poor prognosis of stroke, especially in PwD with ACI (p < 0.05). Conclusion Acute ischemic stroke is associated with elevated serum RAGE level, which, at admission, is an independent predictor of poor outcome for stroke in type 2 diabetes. Keywords Ischemic stroke . Prognosis . RAGE . Type 2 diabetes mellitus
Bin Liu and Xinchun Ye are Co-first authors. * Bin Liu [email protected] * Jingping Shi [email protected] 1
Department of Geriatrics, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, Jiangsu Province, China
2
Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
3
Department Key Laboratory of Research and Application of Animal Models for Environmental and Metabolic Diseases, Shenyang, Liaoning Province, China
4
Department of Neurology, The Affiliated Brain Hospital to Nanjing Medical University, Nanjing Brain Hospital, No. 264,Guangzhou Road, Nanjing 210000, Jiangsu Province, People’s Republic of China
Introduction Diabetes mellitus (DM) complicated with microvascular and macrovascular disease [1] is a major risk factor for stroke [2]. Patients with diabetes (PwD) suffer worse outcome and more recurrent stroke than individuals without diabetes [3, 4]. Therefore, it is necessary to investigate the specific risk factors for PwD with acute ischemic stroke
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