细胞黏附分子和选择素（VCAM-1、ICAM-1、E-选择素、L-选择素和 P-选择素）与 2 型糖尿病患者微血管并发症的关系：一项随访研究。

The association of cell adhesion molecules and selectins (VCAM-1, ICAM-1, E-selectin, L-selectin, and P-selectin) with microvascular complications in patients with type 2 diabetes: A follow-up study.

机构信息

Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

University Diabetes Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

出版信息

Front Endocrinol (Lausanne). 2023 Feb 9;14:1072288. doi: 10.3389/fendo.2023.1072288. eCollection 2023.

DOI:10.3389/fendo.2023.1072288

PMID:36843591

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9948618/

Abstract

OBJECTIVE

Chronic hyperglycemia induces pathogenic changes in the vascular endothelium and leads to the development of microvascular complications in patients with type 2 diabetes mellitus. Early identification of markers of diabetes complications may help to minimize the risk of the development and progression of microvascular complications.

METHODS

This follow-up study was conducted in type 2 diabetic cohort aged between 30-70 years. Out of 160 eligible participants, 70 of them completed follow-up. Levels of cell adhesion molecules and selectins (VCAM-1, ICAM-1, E-selectin, L-selectin and P-selectin) at baseline and follow-up were measured using Randox Evidence biochip analyzer (UK). Development of microvascular complications (diabetic neuropathy, retinopathy and nephropathy) was evaluated.

RESULTS

During the follow-up (2 years, median), 31 (44.3%) developed diabetic neuropathy, 10 (14.3%) developed diabetic retinopathy and, 27 (38.6%) developed diabetic nephropathy. A significant difference in levels of cell adhesion molecules and selectins were found in type 2 diabetic patients with and without microvascular complications. Multiple logistic regression analysis reveals that baseline level of VCAM-1 is significantly associated with microvascular complications; diabetic neuropathy(p=0.028), retinopathy (p=0.007) and nephropathy(p=<0.001). Additionally, levels of P-selectin (p=0.05) and L-selectin (p=0.008) is associated with diabetic nephropathy while retinopathy associated with L-selectin (p=0.005) only.

CONCLUSION

Cell adhesion molecules and selectins are indicators of microvascular complication among patients with type 2 diabetes (T2D). Association of these markers with the development of microvascular complications may provide additive information for developing strategies for diabetes management and prediction of microvascular complications.

摘要

目的

慢性高血糖会引起血管内皮的病变，并导致 2 型糖尿病患者微血管并发症的发生。早期识别糖尿病并发症的标志物有助于降低微血管并发症的发生和进展风险。

方法

本研究为 2 型糖尿病队列的随访研究，纳入年龄在 30-70 岁之间的患者。在 160 名符合条件的参与者中，有 70 名完成了随访。使用 Randox Evidence biochip 分析仪（英国）测量基线和随访时细胞黏附分子和选择素（VCAM-1、ICAM-1、E-选择素、L-选择素和 P-选择素）的水平。评估微血管并发症（糖尿病神经病变、视网膜病变和肾病）的发生情况。

结果

在随访（中位时间 2 年）期间，31 名（44.3%）患者发生糖尿病神经病变，10 名（14.3%）患者发生糖尿病视网膜病变，27 名（38.6%）患者发生糖尿病肾病。有和无微血管并发症的 2 型糖尿病患者的细胞黏附分子和选择素水平存在显著差异。多因素逻辑回归分析显示，基线 VCAM-1 水平与微血管并发症显著相关；与糖尿病神经病变（p=0.028）、视网膜病变（p=0.007）和肾病（p<0.001）相关。此外，P-选择素（p=0.05）和 L-选择素（p=0.008）水平与糖尿病肾病相关，而仅与视网膜病变相关的是 L-选择素（p=0.005）。