Glycosylated hemoglobin, but not advanced glycation end products, predicts severity of coronary artery disease in patients with or without diabetes

Craig Basman; Sarah L Fishman; Dimiter Avtanski; Umar Rashid; Arber Kodra; Karin Chen; Rebecca Jonas; Guillaume J Stoffels; Martin Lesser; Damian Inlall; Karina Ziskovich; Varinder Singh; Leonid Poretsky

doi:10.1016/j.metop.2020.100050

Glycosylated hemoglobin, but not advanced glycation end products, predicts severity of coronary artery disease in patients with or without diabetes

Metabol Open. 2020 Aug 16:7:100050. doi: 10.1016/j.metop.2020.100050. eCollection 2020 Sep.

Authors

Affiliations

¹ Department of Cardiovascular Medicine, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
² Division of Endocrinology and Friedman Diabetes Institute, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
³ Department of Internal Medicine, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
⁴ Biostatics Unit, Feinstein Institute for Medical Research, Northwell Health, Hempstead, NY, USA.

Abstract

Background: The association between coronary artery disease (CAD) and diabetes mellitus (DM) is strong but the physiologic mechanisms responsible for this association remain unclear. Patients with DM exhibit high circulating levels of glycated proteins and lipoproteins called advanced glycation end products (AGEs) which have been implicated in the development of oxidative damage to vascular endothelium. We examined the relationships between the presence and extent of CAD and AGEs in patients undergoing elective coronary artery catheterization in an urban teaching hospital.

Methods: Patients with possible CAD (n = 364) were recruited prior to elective cardiac catheterization (52% male, 48% diabetic). Regression and correlation analyses were used to examine the relationship between serum AGE concentrations, soluble AGE receptor (sRAGE) concentration, HbA_1c, LDL and the presence of obstructive CAD along with the burden of CAD measured by SYNTAX and SYNTAX II scores.

Results: AGE and sRAGE levels did not significantly correlate with any of the studied coronary artery disease parameters. HbA_1c showed positive correlation with both SYNTAX and SYNTAX II scores in patients with and without diabetes.

Conclusion: In this cross-sectional study of patients with possible CAD, serum AGEs and sRAGE concentrations did not correlate with SYNTAX or SYNTAX II scores regardless of diabetic status. HbA1C correlated positively with the SYNTAX and SYNTAX II scores in both diabetic and non-diabetic populations.

Keywords: AGEs, advanced glycation end products; Advanced glycation endproducts; CAD, coronary artery disease; CML- N(6), carboxymethyl-lysine; Coronary artery disease; DM, diabetes mellitus; Diabetes mellitus; HbA1c, hemoglobin A1c; Hemoglobin A1C; LDL, low density lipoprotein; MACCE, Major adverse cardiovascular and/or cerebrovascular events; sRAGE, soluble AGE receptor.