Effect of uncontrolled hyperglycemia on levels of adhesion molecules in patients with diabetes mellitus type 2

未受控制的高血糖对2型糖尿病患者粘附分子的影响（英文）

Objective： Uncontrol ed diabetes has become a major cause of mortality and morbidity by reason of vascular angiopathy. The aim of this study was to evaluate the concentrations of soluble forms of vascular adhesion molecule-1 （sVCAM-1）, intercel ular adhesion molecule-1 （sICAM-1）, E-selectin, and thrombomodulin in patients with wel-control ed and uncontrol ed diabetes type 2. Methods： The study was conducted on 62 patients with diabetes. Group I consisted of 35 patients with wel-control ed diabetes. The second group included 27 patients with uncontrol ed diabetes with micro-albuminuria. A control group was made up of 25 healthy volunteers. The concentrations of sVCAM-1, sICAM-1, sE-selectin, and soluble thrombomodulin were assayed in plasma. Serum concentration of cre-atinine was measured and the plasma concentrations of fasting glucose and glycated hemoglobin （HbA1c） determined. Results： Lower concentrations of ICAM-1 were found in the group of uncontrolled diabetes patients compared with those with wel-control ed disease. In patients with uncontrol ed diabetes, VCAM-1 levels were significantly higher compared with the group with wel-control ed diabetes. In patients with uncontrol ed diabetes a positive correlation was obtained between glomerular filtration rate and sE-selectin and a negative correlation between the levels of creatinine and ICAM-1, although there was a positive correlation between （HbA1c） and ICAM-1. Conclusions： The study con-firmed the participation of the inflammatory process associated with impaired vascular endothelial function in the pathogenesis of type 2 diabetes. The opposite effect of uncontrolled hyperglycemia on adhesion molecules suggests different functions of VCAM-1 and ICAM-1 in complications of diabetes.

目的:评估可溶性血管细胞间黏附分子(s VCAM-1)、可溶性细胞间黏附分子(s ICAM-1)、可溶性选择素E和可溶性血栓调节蛋白在血糖控制良好和不受控制的2型糖尿病患者中的水平。创新点:对2型糖尿病患者的血管内皮炎症标记物进行评估。方法:62例糖尿病患者分成两组:第一组包括35个血糖控制良好的糖尿病患者,第二组包括27个未控制血糖并伴有微蛋白尿的糖尿病患者。对照组由25名健康志愿者组成。测定血浆中s VCAM-1、s ICAM-1、可溶性选择素E和可溶性血栓调节蛋白的浓度,同时测定血清肌酐及血浆中空腹血糖和糖化血红蛋白(Hb A1c)的浓度。结论:与血糖控制良好的糖尿病组相比,未控制血糖组具有相对低的ICAM-1水平和更高的VCAM-1水平。未控制血糖组中患者的糖化血红蛋白和ICAM-1之间呈正相关,肾小球滤过率和可溶性选择素E之间呈正相关,而肌酐和ICAM-1之间呈负相关。研究证实2型糖尿病的发病机理中炎症过程的出现与血管内皮功能受损有关。未受控制的高血糖对粘附分子的反向作用表明,在糖尿病的并发症中VCAM-1和ICAM-1具有不同功能。