sICAM-1是尿白蛋白正常2型糖尿病病人血管病变的早期监测指标

Soluble Intercellular Adhesion Molecule as Early Marker of Vasculopathy in Type 2 Diabetic Patients without Microalbuminuria

为探讨有或无微量白蛋白尿的 2型糖尿病患者血浆sICAM 1 (可溶性细胞间黏附分子 )、sVCAM 1 (可溶性血管细胞黏附分子 )水平的变化 ,并以血浆vWF水平作为内皮功能损伤的指标 ,观察血浆黏附分子水平与vWF水平之间的关系 ,应用ELISA法检测了 82例 2型糖尿病患者 (其中 5 7例尿白蛋白正常、2 5例伴微量白蛋白尿 )的血浆sICAM 1、sVCAM 1、vWF水平 ,并与 2 8例健康人作对照。再将结果与空腹血糖、糖化血红蛋白、尿微量白蛋白、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、空腹胰岛素水平进行相关分析。结果 :在尿白蛋白正常且血浆vWF水平正常的 2型糖尿病患者中 ,血浆sICAM 1水平已有显著升高 (P <0 .0 5 ) ,且与BMI、三酰甘油密切相关。提示 :血浆sICAM 1可替代vWF作为

The aim was to test the hypothesis that endothelial dysfunction is already evident in normoalbuminuric with type 2 diabetes. Previous studies have shown that the development of microalbuminuria is associated with the onset of endothelial dysfunction in individuals with type 2 diabetes. Plasma soluble intercellular adhesion molecule(sICAM-1), soluble vascular cell adhesion molecule(sVCAM-1), vWF were measured by ELISA in 28 healthy control subjects(groupⅠ), 57 normoalbuminuria individuals with type 2 diabetes(groupⅡ), and 25 microalbuminuria individuals with type 2 diabetes(groupⅢ). Plasma sICAM-1 levels were significantly higher in the groupⅡ and groupⅢ than that in the groupⅠ(P<0.05). In contrast plasma sVCAM-1 and vWF levels were elevated only in the groupⅢ compared with groupⅡ and groupⅠ(P<0.05). Correlated analysis showed a significant positive correlation between sICAM-1 and blood pressure,triglyceride, vWF, sVCAM-1. The results suggest that plasma sICAM-1 levels might be implicated in the development of diabetic vasculopathy, and could predict the onset of endothelial dysfunction instead of plasma vWF levels. The measurement of plasma sICAM-1 levels in type 2 diabetic patients may be clinically useful for early discovering of endothelial dysfunction.