Soedamah-Muthu Sabita S, Chaturvedi Nish, Schalkwijk Casper G, Stehouwer Coen D A, Ebeling Pertti, Fuller John H
Department of Epidemiology and Public-Health, Royal Free and University College London Medical School, London, UK, and Department of Internal Medicine, University Hospital Maastricht, The Netherlands.
J Diabetes Complications. 2006 May-Jun;20(3):188-95. doi: 10.1016/j.jdiacomp.2005.06.005.
There are no large studies in Type 1 diabetic patients that have examined the relation between soluble adhesion molecules and micro- and macrovascular outcomes, although the risks of such complications are high. Therefore, the main objective is to examine the relationship between soluble (s) vascular cell adhesion molecule-1 (sVCAM-1) and sE-selectin and retinopathy, albuminuria, and cardiovascular disease (CVD) in Type 1 diabetic patients.
Cross-sectional data on 540 Type 1 diabetic patients, with a mean age of 40 years and diabetes duration of 22 years, from the EURODIAB Prospective Complications Study (PCS) were analysed. Retinopathy was assessed by centrally graded retinal photographs. Albumin excretion rate (AER) was used to define micro- and macroalbuminuria. CVD was defined as having physician diagnosed myocardial infarction (MI), stroke, coronary artery bypass graft (CABG) or angina, or Minnesota coded ischaemic electrocardiograms (ECGs).
Unadjusted, there was a positive relationship between sVCAM-1 and sE-selectin with nonproliferative and proliferative retinopathy, micro- and macroalbuminuria, and CVD. After adjustment for age, sex, duration of diabetes, systolic blood pressure (BP), LDL-cholesterol, fasting triglycerides (TGs), smoking, body mass index (BMI), and glycated haemoglobin, as well as other complications, the strongest significant associations were shown between sVCAM-1 and macroalbuminuria, with an odds ratio of 1.83 (1.33-2.53) for every 100 ng/ml increase in sVCAM-1.
In this large sample of Type 1 diabetic patients, it was shown that sVCAM-1 and sE-selectin have positive associations with retinopathy, albuminuria, and CVD. This suggests that adhesion molecules are important in the pathogenesis of vascular complications in Type 1 diabetes.
尽管1型糖尿病患者发生微血管和大血管并发症的风险很高，但尚无大型研究探讨可溶性黏附分子与微血管和大血管病变之间的关系。因此，主要目的是研究1型糖尿病患者中可溶性血管细胞黏附分子-1（sVCAM-1）和可溶性E选择素与视网膜病变、蛋白尿和心血管疾病（CVD）之间的关系。
分析了欧洲糖尿病前瞻性并发症研究（PCS）中540例1型糖尿病患者的横断面数据，这些患者的平均年龄为40岁，糖尿病病程为22年。视网膜病变通过中心分级的视网膜照片进行评估。白蛋白排泄率（AER）用于定义微量白蛋白尿和大量白蛋白尿。CVD定义为经医生诊断为心肌梗死（MI）、中风、冠状动脉搭桥术（CABG）或心绞痛，或明尼苏达编码的缺血性心电图（ECG）。
未经调整时，sVCAM-1和sE选择素与非增殖性和增殖性视网膜病变、微量和大量白蛋白尿以及CVD之间存在正相关关系。在对年龄、性别、糖尿病病程、收缩压（BP）、低密度脂蛋白胆固醇、空腹甘油三酯（TGs）、吸烟、体重指数（BMI）、糖化血红蛋白以及其他并发症进行调整后，sVCAM-1与大量白蛋白尿之间显示出最强的显著关联，sVCAM-1每增加100 ng/ml，比值比为1.83（1.33-2.53）。
在这个大型的1型糖尿病患者样本中，研究表明sVCAM-1和sE选择素与视网膜病变、蛋白尿和CVD呈正相关。这表明黏附分子在1型糖尿病血管并发症的发病机制中很重要。
