Soluble Receptor for Advanced Glycation End-Products (sRAGE), Glycemic, and Lipid Indices in Diabetic Patients With and Without Microvascular Complications: A Cross-Sectional Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background and objective Microvascular complications and insulin resistance in patients with type 2 diabetes mellitus (T2DM) increase the healthcare burden. The homeostatic model assessment of insulin resistance (HOMA-IR) and fasting insulin concentrations are widely used to assess insulin resistance. In resource-limited settings, the triglyceride-glucose (TyG) index is preferred as an alternative measure of insulin resistance. There is debate about the impact of soluble receptor for advanced glycation end-products (sRAGE) on microvascular complications and insulin resistance. However, Indian studies exploring this association are scarce. Therefore, we planned to evaluate sRAGE levels, fasting serum insulin, HOMA-IR, and the TyG index in diabetic individuals with and without microvascular complications. We also analyzed the correlation between sRAGE and other parameters. Methods This cross-sectional study was conducted from July 2024 to June 2026 at Kalinga Institute of Medical Sciences, Bhubaneswar, India. Adults with T2DM were enrolled in this study. Those participating in any other research projects were excluded. The study participants were grouped according to the number of microvascular complications (i.e., 0, 1, 2, or 3). We evaluated and compared the following parameters among participants in the four groups: age, duration of T2DM, BMI, fasting blood sugar (FBS), glycated hemoglobin (HbA1c), serum creatinine, estimated glomerular filtration rate (eGFR), serum insulin, serum triglycerides, serum total cholesterol, and sRAGE levels. HOMA-IR and the TyG index were calculated for the participants. We also assessed correlations between sRAGE levels and the collected parameters. We used R software (version 4.6.2; R Foundation for Statistical Computing, Vienna, Austria) for data analysis. Results Our study population consisted of 151 patients with diabetes (median age, 54.0 (46.0-63.5) years; 86 males (56.95%)), with a median T2DM duration of 12 years and a median BMI of 27.11 (25.52-28.90) kg/m². Of the 151 participants, 57 (37.75%) had one of the three microvascular complications, 33 (21.85%) had two complications, and 23 (15.23%) had three complications. Thirty-eight participants (25.17%) had no microvascular complications. The median serum creatinine and eGFR levels were 0.91 (0.81-1.96) mg/dL and 71.76 (29.09-95.03) mL/min/1.73 m², respectively. The median FBS, HbA1c, and fasting insulin levels were 189.0 (163.5-217.0) mg/dL, 7.31 (7.03-7.89%), and 4.91 (4.04-6.03) µIU/mL, respectively. The median serum total cholesterol and triglyceride levels were 178.0 (153.0-203.0) mg/dL and 136.0 (116.0-161.5) mg/dL, respectively. The median sRAGE level in the study population was 276.4 (201.8-413.9) pg/mL. The median HOMA-IR and TyG index values were 2.18 (1.78-3.03) and 9.44 (9.22-9.71), respectively. There were negative correlations between sRAGE and serum creatinine (r = -0.561, p < 0.001) and the TyG index (r = -0.332, p < 0.001). The correlation between sRAGE and serum insulin (r = 0.220, p = 0.007) was weakly positive. The correlation between sRAGE and HOMA-IR (r = -0.002, p = 0.976) was not statistically significant. Conclusions We found reduced sRAGE levels among participants with microvascular complications. The TyG index and HOMA-IR values were higher among participants with two to three complications. We did not observe strong correlations between sRAGE and any of the studied parameters.
Source: Cureus
Language: English
Subfield: Clinical Biochemistry
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7216284432