Effect of uncontrolled hyperglycemia on levels of adhesion molecules in patients with diabetes mellitus type 2

ObjectiveUncontrolled diabetes has become a major cause of mortality and morbidity by reason of vascular angiopathy. The aim of this study was to evaluate the concentrations of soluble forms of vascular adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), E-selectin, and thrombomodulin in patients with well-controlled and uncontrolled diabetes type 2.MethodsThe study was conducted on 62 patients with diabetes. Group I consisted of 35 patients with well-controlled diabetes. The second group included 27 patients with uncontrolled diabetes with micro-albuminuria. A control group was made up of 25 healthy volunteers. The concentrations of sVCAM-1, sICAM-1, sE-selectin, and soluble thrombomodulin were assayed in plasma. Serum concentration of creatinine was measured and the plasma concentrations of fasting glucose and glycated hemoglobin (HbA1c) determined.ResultsLower concentrations of ICAM-1 were found in the group of uncontrolled diabetes patients compared with those with well-controlled disease. In patients with uncontrolled diabetes, VCAM-1 levels were significantly higher compared with the group with well-controlled diabetes. In patients with uncontrolled diabetes a positive correlation was obtained between glomerular filtration rate and sE-selectin and a negative correlation between the levels of creatinine and ICAM-1, although there was a positive correlation between (HbA1c) and ICAM-1.ConclusionThe study confirmed the participation of the inflammatory process associated with impaired vascular endothelial function in the pathogenesis of type 2 diabetes. The opposite effect of uncontrolled hyperglycemia on adhesion molecules suggests different functions of VCAM-1 and ICAM-1 in complications of diabetes.概要目的评估可溶性血管细胞间黏附分子 (sVCAM-1)、可溶性细胞间黏附分子 (sICAM-1)、可溶性选择素E 和可溶性血栓调节蛋白在血糖控制良好和不受控制的2 型糖尿病患者中的水平。创新点对2 型糖尿病患者的血管内皮炎症标记物进行评估。方法62 例糖尿病患者分成两组: 第一组包括35 个血糖控制良好的糖尿病患者, 第二组包括27 个未控制血糖并伴有微蛋白尿的糖尿病患者。对照组由25 名健康志愿者组成。测定血浆中sVCAM-1、sICAM-1、可溶性选择素E 和可溶性血栓调节蛋白的浓度, 同时测定血清肌酐及血浆中空腹血糖和糖化血红蛋白 (HbA1c) 的浓度。结论与血糖控制良好的糖尿病组相比, 未控制血糖组具有相对低的ICAM-1 水平和更高的VCAM-1 水平。未控制血糖组中患者的糖化血红蛋白和ICAM-1 之间呈正相关, 肾小球滤过率和可溶性选择素E 之间呈正相关, 而肌酐和ICAM-1 之间呈负相关。研究证实2 型糖尿病的发病机理中炎症过程的出现与血管内皮功能受损有关。未受控制的高血糖对粘附分子的反向作用表明, 在糖尿病的并发症中VCAM-1和ICAM-1具有不同功能。