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International Angiology 2004 March;23(1):18-24


language: English

Increased soluble E-selectin levels in type 2 diabetic patients with peripheral arterial disease

Boulbou M. S. 1, Koukoulis G. N. 2, Vasiou K. G. 3, Petinaki E. A. 4, Gourgoulianis K. I. 1, Fezoulidis I. B. 3

1 Department of Physiology, Medical School, University of Thessaly, Larissa, Greece 2 Department of Endocrinology and Metabolism, Medical School, University of Thessaly, Larissa, Greece 3 Department of Radiology, Medical School, University of Thessaly, Larissa, Greece 4 Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece


Aim. Abnor­mal endo­the­lial func­tion is well known in ­patients with type 2 dia­betes mel­lit­us and ­thought to ­induce mac­ro­an­gio­pa­thy. ­Increased lev­els of adhe­sion mole­cules have been found in type 2 dia­bet­ic ­patients and it has been sug­gest­ed that they play an impor­tant role in the initi­a­tion of ath­ero­scler­o­sis. The aim of the ­present study was to clar­i­fy the rela­tion­ship ­between objec­tive­ly prov­en periph­er­al arte­ri­al dis­ease (pAVD) and serum lev­els of sol­u­ble adhe­sion mole­cules in ­patients with type 2 dia­betes mel­lit­us.
Meth­ods. Lev­els of sol­u­ble E-selec­tin, ICAM-1 and VCAM-1 were eval­u­at­ed in 18 type 2 dia­bet­ic ­patients with pAVD ­assessed by Dop­pler ultra­sound, in 19 type 2 dia­bet­ic ­patients and 22 non-dia­bet­ic sub­jects with­out pAVD.
­Results. Sol­u­ble E-selec­tin lev­els were sig­nif­i­cant­ly ­increased in pAVD-dia­bet­ic ­patients com­pared to dia­bet­ics and non-dia­bet­ics with­out pAVD (78.7±29 vs 49.7±20.4 and 36±17 ng/ml respec­tive­ly, p<0.001), while sICAM-1 and sVCAM-1 lev­els were com­par­able ­between the ­groups. No sig­nif­i­cant cor­re­la­tion was found ­between pAVD and adhe­sion mole­cule lev­els. Periph­er­al AVD was cor­re­lat­ed with smok­ing (p=0.024), dura­tion of dia­betes (p=0.048) and micro­al­bu­mi­nu­ria (p=0.041). Regres­sion anal­y­sis ­revealed that only smok­ing (R=0.536, p=0.012) and gly­cos­y­lat­ed hemo­glo­bin (R=0.435, p=0.036) were inde­pen­dent fac­tors relat­ed to pAVD. Sol­u­ble ICAM-1 lev­els were sig­nif­i­cant­ly high­er (p=0.041) in dia­bet­ic smok­ers with pAVD and sVCAM-1 (p=0.011) in ­patients with long­er dura­tion of dia­betes.
Con­clu­sion. Type 2 dia­bet­ic ­patients with pAVD ­showed ­increased serum sE-selec­tin lev­els. No sig­nif­i­cant rela­tion­ship was found ­between the pres­ence or ­extent of pAVD and meas­ured adhe­sion mole­cules. Our ­results sug­gest that sE-selec­tin ­reflects endo­the­lial acti­va­tion and is pos­sibly ­involved in the ather­o­gen­e­sis pro­cess with the con­tri­bu­tion of other fac­tors that char­ac­ter­ize the meta­bol­ic syn­drome of dia­betes.

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