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Serum biomarkers, skin autofluorescence and other methods. Which parameter better illustrates the relationship between advanced glycation end products and arterial stiffness in the general population?

Hypertension Research volume 44, pages 518–527 (2021)Cite this article

Abstract

Stiffening of large arteries, clinically manifesting as increased aortic pulse wave velocity (PWV), is an inevitable outcome of aging. Among other mechanisms, impaired glucose metabolism plays an important role, leading to the deposition of advanced glycation end products (AGEs). This process is counterbalanced by the circulating soluble receptor for AGEs (sRAGE). We investigated the association between arterial stiffness on one side and multiple circulating biomarkers and the degree of skin deposition of AGEs on the other. In a cross-sectional design, 867 participants based on a general population sample (Czech post-MONICA studies) were examined. PWV was measured by SphygmoCor device (AtCor Medical Ltd.), while skin AGEs were measured using a dedicated autofluorescence method (AGE Reader mu®). To quantify the circulating status of AGEs, carboxymethyl lysine (CML) and sRAGE concentrations were assessed by ELISA, along with conventional glucose metabolism indicators. When analyzing the whole sample using multiple linear or logistic regression models and after adjustment for potential covariates, a significant association with PWV was found for fasting glycemia, HbA1c, sRAGE, skin AGEs, and the skin AGE-to-sRAGE ratio. Among these parameters, stepwise models identified the strongest association for the skin AGEs and AGE-to-sRAGE ratio, and this was also true when diabetic subjects were excluded. In contrast, neither CML nor its ratio relative to sRAGE showed any association with arterial stiffness. In conclusion, skin AGEs along with their ratio relative to sRAGE were closely associated with arterial stiffness and is a better indicator of the current status of deposited AGEs than other relevant factors.

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Acknowledgements

We would like to acknowledge the hard work of all investigators and other coworkers (study nurses, laboratory technicians, medical students, etc.) who participated in the post-MONICA projects and, last but not least, all study subjects who voluntarily responded to the very time-consuming clinical examination program. The study realization was supported by the Health Development Agency of Czech Ministry of Health (project 15-27109), Charles University Research Fund (PROGRES, project Q39), and by Ministry of Health, Czech Republic - conceptual development of research organization. (FNPl, 00669806).

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Authors and Affiliations

  1. 2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czech Republic

    Július Gelžinský, Otto Mayer Jr., Jitka Seidlerová, Markéta Mateřánková, Štěpán Mareš, Veronika Kordíkova & Jan Filipovský

  2. Biomedical Center, Medical Faculty of Charles University, Pilsen, Czech Republic

    Július Gelžinský, Otto Mayer Jr., Jitka Seidlerová, Markéta Mateřánková, Štěpán Mareš, Veronika Kordíkova & Jan Filipovský

  3. Department of Clinical Biochemistry and Hematology, University Hospital, Pilsen, Czech Republic

    Ladislav Trefil

  4. Centre for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic

    Renata Cífková

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  1. Július Gelžinský
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Gelžinský, J., Mayer, O., Seidlerová, J. et al. Serum biomarkers, skin autofluorescence and other methods. Which parameter better illustrates the relationship between advanced glycation end products and arterial stiffness in the general population?. Hypertens Res 44, 518–527 (2021). https://doi.org/10.1038/s41440-020-00601-1

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