| Objective and BackgroundDue to the change of lifestyle and the improvement of life level, the number of type2 diabetes (T2DM), worldwide will grow rapidly. The patients with T2DM are liable to complicate with macrovascular complications. This is the main reason of death and cripple in diabetic patients. It is reported that the diabetic patients are two to four times more likely to die of coronary artery disease than matched controls. CAMs are cell surface proteins involved in the binding of leucocytes to each other, endothelial cells or the extracellular matrix. Recently, attention has been focused on CAMs in the pathogenesis of atherosclerosis. The binding of leucocytes to endothelial cells is a crucial step in the development of inflammatory lesions on the vascular wall. Attachment to an increasingly 'sticky' endothelium and transmigration into the vascular wall is mediated by the expression of the CAMs by activatedendothelial cells. Intercellular adhesion molecule-1 (ICAM-1) is one of the most important CAMs. ICAM-1 has been demonstrated in endothelium overlying atherosclerotic plaques, and ICAM-1 and endothelial-specific E-selectin are associated with atherosclerotic lesions.ICAM-1 and E-selectin have been shown to predict carotid artery atherosclerosis and incident coronary heart disease in the Atherosclerotic Risk In Communities (ARIC) Study, and the prospective Physicians Health Study implicated ICAM-1 in the development of atherogenesis and coronary artery disease. However, to date, there have been very few reports implicating sICAM-1 in the development of diabetic macrovascular complications. CRP is a sensitive maker of imflammation. CRP could contribute to the accelerated atherogenesis. It is hypothesized that Atherosclerosis and T2DM may share common antecedents, this is the "common soil" hypothesis. Within a diabetic subpopulation, may CRP also be a strong predictor of macrovascular disease? To investigate the associations between soluble intercellular adhesion molecule-1(sICAMs) and high-sensitivity CRP with atherosclerosis in T2DM, sICAM-1 and CRP levels were evaluated in 55 T2DM with or without atherosclerosis and 25 normal comtrols. MethodsFifty-five T2DM patients (group T2DM) (34 men and 21 women aged 61.3 ± 6.4 years [mean ± SD]; body mass index [BMI], (24.4 ±2.7kg/m2) and twenty-five normal control (group A) matched for sex (sixteen men and nine women), age (58.7 ±7.0 years), were enrolled for the present study. T2DM was diagnosed based on World Health Organization criteria in 1999. We selected the subjects without insulin treatment. All T2DM patients were divided into two groups according to carotidatherosclerosis. Group B (n=33): patiens without carotid atherosclerosis; group C (n=22): patients complicated with carotid atherosclerosis. Excluded from the study were patients who had significsnt renal or liver dysfunction, active infection, malignant tumor, hematological disorders, or acute diabetic complications. All patient had normal blood and urine routine. The intima-media thickness of common carotid artery (CCA-IMT) was measured using highresolution B-mode ultrasonography with an electronic linear transducer (mid-frequency, 7.5-10 MHz). Localized thickening of > 1.2 mm was considered as plaque. A CCA-IMT level ≥ 1.0mm or plaque were designated as carotid atherosclerosis.All subjects had lying blood pressure (BP), measured twice, in the right arm. BMI was calculated by weight (kg) / height (m2). Blood from an antecubital vein was collected after an overnight fast. All patients had fasting glucose (glucose oxidase), serum total cholesterol, triglyceride, HDL-cholesterol, CRP, and LDL-cholesterol concentrations measured using standard procedures. Serum for sICAM-1 was separated after centrifuging the sample at 3000 rpm for 10 min, and the serum obtained was stored at -70℃ until analysis. sICAM-1 was measured using commercially available ELISA kits (DIACLONE, France).Serum samples were assayed for CRP using an high-sensitivity particle enhanced immunonephelometry on a BN II analyzer. The res...
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