Głowińska Barbara, Urban Mirosława, Peczyńska Jadwiga, Szczepańska-Kostro Jolanta
II Klinika Chorób Dzieci Akademii Medycznej w Białymstoku.
Pol Merkur Lekarski. 2003 Mar;14(81):205-9.
Atherosclerotic process is accelerated in children with atherosclerosis risk factors, such as type 1 diabetes. Infiltration of the vessel wall by monocytes and lymphocytes, which starts atherosclerotic process, takes place under influence of adhesion molecules. Adhesion molecules play an important role in the first stage of atherosclerosis, and it is suggested that expression of adhesion molecules in children can be greater than in adults. The aim of the study was to evaluate the concentration of soluble forms of adhesion molecules slCAM-1 and sVCAM-1 in children and adolescents with type 1 diabetes. The concentration of adhesion molecules was additionally assessed depending on metabolic compensation, complications, diabetes duration and family history of cardiovascular disease.
The study was carried out in 28 children and adolescents with type 1 diabetes, aged 10.5-18 years (mean 15.3), with diabetes duration 5-15 years (8.1); mean HbA1c level during last six months was 6-11.4% (8.2%). Control group included 16 healthy, slim children aged 11-18 years (15.5). slCAM-1 and sVCAM-1 levels were assessed by means of immunoenzymatic methods (Parameter Human soluble lCAM-1 Immunoassay, Parameter Human soluble VCAM-1 Immunoassay, R&D Systems).
slCAM-1 concentration in diabetic children was 305 +/- 71 ng/dl and was significantly higher than in controls--262.1 +/- 59 ng/dl (p = 0.04). sVCAM-1 concentration in diabetic children was 499.5 +/- 162 ng/dl and did not differ from the controls--446.3 +/- 95 (ns). In 5 children with positive family history of cardiovascular disease we found significantly higher slCAM-1 level: 323 +/- 72 ng/dl vs 244 +/- 30 ng/dl in children with negative family history (p < 0.05). The level of slCAM was slightly higher in ill children with worse metabolic compensation (314 +/- 90 ng/dl in group with HbA1c > 8%, 322 +/- 84 ng/dl in group with HbA1c < 8% but > 7%, and 285 +/- 68 ng/dl in group with HbA1c < 7%). We found a significant correlation between HbA1c and slCAM-1 (r = 0.39, p = 0.014) as well as between BMI and sVCAM-1 (r = 0.39, p = 0.044).
在患有动脉粥样硬化危险因素（如1型糖尿病）的儿童中，动脉粥样硬化进程会加速。单核细胞和淋巴细胞对血管壁的浸润启动了动脉粥样硬化进程，这一过程在黏附分子的影响下发生。黏附分子在动脉粥样硬化的第一阶段起重要作用，并且有人提出儿童中黏附分子的表达可能高于成年人。本研究的目的是评估1型糖尿病儿童和青少年中可溶性黏附分子slCAM-1和sVCAM-1的浓度。此外，还根据代谢补偿、并发症、糖尿病病程和心血管疾病家族史对黏附分子的浓度进行了评估。
本研究对28例1型糖尿病儿童和青少年进行，年龄在10.5 - 18岁（平均15.3岁），糖尿病病程5 - 15年（8.1年）；过去六个月的平均糖化血红蛋白水平为6 - 11.4%（8.2%）。对照组包括16名健康、体型苗条的儿童，年龄在11 - 18岁（15.5岁）。通过免疫酶法（参数人可溶性ICAM-1免疫测定法、参数人可溶性VCAM-1免疫测定法，R&D系统）评估slCAM-1和sVCAM-1水平。
糖尿病儿童中slCAM-1浓度为305±71 ng/dl，显著高于对照组——262.1±59 ng/dl（p = 0.04）。糖尿病儿童中sVCAM-1浓度为499.5±162 ng/dl，与对照组无差异——446.3±95（无显著性差异）。在5名有心血管疾病家族史阳性的儿童中，我们发现slCAM-1水平显著更高：323±72 ng/dl，而家族史阴性的儿童为244±30 ng/dl（p < 0.05）。代谢补偿较差的患病儿童中slCAM水平略高（糖化血红蛋白＞8%组为314±90 ng/dl，糖化血红蛋白＜8%但＞7%组为322±84 ng/dl，糖化血红蛋白＜7%组为285±68 ng/dl）。我们发现糖化血红蛋白与slCAM-1之间存在显著相关性（r = 0.39，p = 0.014），以及体重指数与sVCAM-1之间存在显著相关性（r = 0.39，p = 0.044）。
