Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis
AimAdvanced glycation end products (AGEs) are pivotal mediators in diabetic kidney disease (DKD). However, their prognostic utility remains underexplored. This study introduced corrected lgAGEs [novel biomarker derived by adjusting logarithmically transformed AGEs (lgAGEs) levels based on serum albu...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2025.1541198/full |
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| author | Ze-Hou Wang Ze-Hou Wang Zong-Jin Zhang Yue-Fen Wang Jin Xie Jin Xie Yi-Min Li Cun Shen Yuan Meng Wen-Jing Zhao Lu-Ying Sun Wei Jing Liu |
| author_facet | Ze-Hou Wang Ze-Hou Wang Zong-Jin Zhang Yue-Fen Wang Jin Xie Jin Xie Yi-Min Li Cun Shen Yuan Meng Wen-Jing Zhao Lu-Ying Sun Wei Jing Liu |
| author_sort | Ze-Hou Wang |
| collection | DOAJ |
| description | AimAdvanced glycation end products (AGEs) are pivotal mediators in diabetic kidney disease (DKD). However, their prognostic utility remains underexplored. This study introduced corrected lgAGEs [novel biomarker derived by adjusting logarithmically transformed AGEs (lgAGEs) levels based on serum albumin (ALB) levels] to enhance the prediction of adverse renal outcomes in patients with type 2 DKD (T2DKD).MethodsIn this prospective cohort study, 196 T2DKD patients were followed up longitudinally. Serum AGEs levels were log-transformed and adjusted for ALB to calculate corrected lgAGEs. Participants were stratified into the high- and low-level groups based on the median corrected lgAGEs. The association between corrected lgAGEs and renal outcomes was assessed using Cox proportional hazards models. Receiver operating characteristic (ROC) curve was utilized to evaluate the predictive performance of corrected lgAGEs alone and in combination with the urinary albumin-to-creatinine ratio (UACR).ResultsHigh level of corrected lgAGEs was independently associated with adverse renal outcomes [hazard ratio (HR), 3.252; 95% confidence interval (CI), 1.461–7.243; p = 0.003]. Kaplan-Meier analysis demonstrated that patients in the high-level group (12 months) exhibited significantly shorter median survival times compared with those in the low-level group (50 months). ROC analysis showed that UACR alone had an area under the curve (AUC) of 0.782 (95% CI, 0.705–0.858), with 82.8% sensitivity and 61.5% specificity. Corrected lgAGEs achieved an AUC of 0.725 (95% CI, 0.637–0.814), with 69.0% sensitivity and 76.9% specificity. Combining UACR and corrected lgAGEs improved the specificity to 75.6%, with an AUC of 0.764 (95% CI, 0.682–0.847), while maintaining a sensitivity of 70.7%.ConclusionCorrected lgAGEs are novel and independent biomarkers for predicting adverse renal outcomes in T2DKD. Combining UACR with corrected lgAGEs could enhance risk stratification by improving the specificity, highlighting its potential application in early identification of high-risk patients. These findings should be validated in broader populations in future research. |
| format | Article |
| id | doaj-art-e11a9dddbeb54601983892d0ced2343c |
| institution | Kabale University |
| issn | 1664-042X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj-art-e11a9dddbeb54601983892d0ced2343c2025-01-31T06:39:53ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-01-011610.3389/fphys.2025.15411981541198Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosisZe-Hou Wang0Ze-Hou Wang1Zong-Jin Zhang2Yue-Fen Wang3Jin Xie4Jin Xie5Yi-Min Li6Cun Shen7Yuan Meng8Wen-Jing Zhao9Lu-Ying Sun10Wei Jing Liu11Department of Nephrology, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, ChinaBeijing University of Chinese Medicine, Beijing, ChinaDepartment of Traditional Chinese Medicine, Majiapu Community Health Service Center, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaBeijing University of Chinese Medicine, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Geriatrics, Nantong Traditional Chinese Medicine Hospital, Nantong, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Fangshan Hospital Beijing University of Chinese Medicine, Beijing, ChinaKey Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaAimAdvanced glycation end products (AGEs) are pivotal mediators in diabetic kidney disease (DKD). However, their prognostic utility remains underexplored. This study introduced corrected lgAGEs [novel biomarker derived by adjusting logarithmically transformed AGEs (lgAGEs) levels based on serum albumin (ALB) levels] to enhance the prediction of adverse renal outcomes in patients with type 2 DKD (T2DKD).MethodsIn this prospective cohort study, 196 T2DKD patients were followed up longitudinally. Serum AGEs levels were log-transformed and adjusted for ALB to calculate corrected lgAGEs. Participants were stratified into the high- and low-level groups based on the median corrected lgAGEs. The association between corrected lgAGEs and renal outcomes was assessed using Cox proportional hazards models. Receiver operating characteristic (ROC) curve was utilized to evaluate the predictive performance of corrected lgAGEs alone and in combination with the urinary albumin-to-creatinine ratio (UACR).ResultsHigh level of corrected lgAGEs was independently associated with adverse renal outcomes [hazard ratio (HR), 3.252; 95% confidence interval (CI), 1.461–7.243; p = 0.003]. Kaplan-Meier analysis demonstrated that patients in the high-level group (12 months) exhibited significantly shorter median survival times compared with those in the low-level group (50 months). ROC analysis showed that UACR alone had an area under the curve (AUC) of 0.782 (95% CI, 0.705–0.858), with 82.8% sensitivity and 61.5% specificity. Corrected lgAGEs achieved an AUC of 0.725 (95% CI, 0.637–0.814), with 69.0% sensitivity and 76.9% specificity. Combining UACR and corrected lgAGEs improved the specificity to 75.6%, with an AUC of 0.764 (95% CI, 0.682–0.847), while maintaining a sensitivity of 70.7%.ConclusionCorrected lgAGEs are novel and independent biomarkers for predicting adverse renal outcomes in T2DKD. Combining UACR with corrected lgAGEs could enhance risk stratification by improving the specificity, highlighting its potential application in early identification of high-risk patients. These findings should be validated in broader populations in future research.https://www.frontiersin.org/articles/10.3389/fphys.2025.1541198/fulladvanced glycation end products (AGEs)diabetic kidney disease (DKD)corrected lgAGEsurinary albumin-to-creatinine ratio (UACR)renal prognosis |
| spellingShingle | Ze-Hou Wang Ze-Hou Wang Zong-Jin Zhang Yue-Fen Wang Jin Xie Jin Xie Yi-Min Li Cun Shen Yuan Meng Wen-Jing Zhao Lu-Ying Sun Wei Jing Liu Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis Frontiers in Physiology advanced glycation end products (AGEs) diabetic kidney disease (DKD) corrected lgAGEs urinary albumin-to-creatinine ratio (UACR) renal prognosis |
| title | Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis |
| title_full | Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis |
| title_fullStr | Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis |
| title_full_unstemmed | Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis |
| title_short | Serum advanced glycation end products as a putative biomarker in Type2 DKD patients’ prognosis |
| title_sort | serum advanced glycation end products as a putative biomarker in type2 dkd patients prognosis |
| topic | advanced glycation end products (AGEs) diabetic kidney disease (DKD) corrected lgAGEs urinary albumin-to-creatinine ratio (UACR) renal prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2025.1541198/full |
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