Serum of advanced glycation end products in Tunisian diabetic patients with chronic kidney disease

Abstract

Advanced glycation end products (AGEs) and their receptors are prominent contributors to diabetic
renal disease and clinical importance of AGEs toxicity had been rarely reported. We measured serum
AGE, sRAGE and pentosidine levels in diabetic patients with and without nephropathy and examined
whether these biomarkers are related to renal function impairment. We included 30 healthy control
subjects and 100 diabetic patients who were further divided into 2 subgroups: one with 30 patients who
had normal eGFR, the other with 70 patients who had reduced eGFR. AGEs, sRAGE and pentosidine
were measured in serum by ELISA. Serum levels of AGEs, sRAGE and pentosidine were significantly
increased in diabetic patients compared to controls (579.78 ± 113.28 vs. 508.83 ± 119.68 pg/ml; 169.17 ±
30.41 vs. 148.72 ± 32.73 pg/ml; 247.84 ± 21.42 vs. 214.03 ± 55.05 pg/ml, P < 0.001, P < 0.01, P < 0.05
respectively). Diabetic patients with chronic kidney disease (CKD) showed an increased level of AGEs,
sRAGE and pentosidine compared to diabetic patients without CKD (P < 0.01, P < 0.05, P < 0.05
respectively). In diabetic patients who had reduced eGFR, serum AGEs, sRAGE and pentosidine levels
were significantly higher in patients with eGFR< 60, than in those with 60<eGFR<90 ml/min/1.73 m
2
(P <
0.001, P < 0.01, P < 0.001 respectively). Serum creatinine was positively associated with AGEs and
sRAGE. In stepwise multivariate regression analysis, AGEs and sRAGE were independently associated
with decreased renal function. Serum AGEs, sRAGE, and pentosidine levels are related with the
presence and the severity of diabetic nephropathy in Tunisian population.