Matsumoto K, Sera Y, Ueki Y, Inukai G, Niiro E, Miyake S
Departments of Diabetes & Metabolism, Sasebo Chuo Hospital, Nagaski, Japan.
Diabet Med. 2002 Oct;19(10):822-6. doi: 10.1046/j.1464-5491.2002.00799.x.
To clarify the correlation between serum concentrations of soluble adhesion molecules and diabetic microangiopathy or macroangiopathy in patients with Type 2 diabetes.
Patients with diabetic retinopathy and intima-media thickness of common carotid artery (CCA-IMT) < 1.1 mm were classified as the microangiopathy group (n = 62). Patients with CCA-IMT > or = 1.1 mm and without retinopathy were classified as the macroangiopathy group (n = 95). Patients with CCA-IMT < 0.9 mm and without retinopathy were assigned to the no complications group (n = 139). Clinical characteristics and soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin levels were compared between the groups.
Patients with microangiopathy had a significantly longer duration of diabetes, were hypertensive and more likely to have a positive family history of diabetes than the control group. Patients with macroangiopathy were more likely to be smokers, hypertensive, and have a family history of hypertension. Soluble ICAM-1, VCAM-1, and E-selectin levels were significantly higher in the microangiopathy group than in the control group. Soluble VCAM-1 and E-selectin levels, but not ICAM-1 levels, were significantly elevated in the macroangiopathy group. These results were unchanged after adjustment for age, sex, duration of diabetes, blood pressure, HbA1c, HDL-cholesterol, and smoking status.
Our results suggest that soluble adhesion molecules are related to both diabetic micro- and macroangiopathy. The relative contributions of adhesion molecules may be greater in the former than latter patients with Type 2 diabetes.
阐明2型糖尿病患者血清可溶性黏附分子浓度与糖尿病微血管病变或大血管病变之间的相关性。
将患有糖尿病视网膜病变且颈总动脉内膜中层厚度(CCA-IMT)<1.1mm的患者归为微血管病变组(n = 62)。将CCA-IMT≥1.1mm且无视网膜病变的患者归为大血管病变组(n = 95)。将CCA-IMT<0.9mm且无视网膜病变的患者归为无并发症组(n = 139)。比较三组患者的临床特征以及可溶性细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)和E-选择素水平。
与对照组相比,微血管病变患者的糖尿病病程显著更长,患有高血压且糖尿病家族史阳性的可能性更大。大血管病变患者更有可能是吸烟者、患有高血压且有高血压家族史。微血管病变组的可溶性ICAM-1、VCAM-1和E-选择素水平显著高于对照组。大血管病变组的可溶性VCAM-1和E-选择素水平显著升高,但ICAM-1水平未升高。在对年龄、性别、糖尿病病程、血压、糖化血红蛋白、高密度脂蛋白胆固醇和吸烟状况进行校正后,这些结果不变。
我们的结果表明,可溶性黏附分子与糖尿病微血管病变和大血管病变均相关。在2型糖尿病患者中,黏附分子在前一种病变中的相对作用可能比后一种更大。