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2型糖尿病及高血压患者的循环黏附分子水平

Circulating adhesion molecules levels in type 2 diabetes mellitus and hypertension
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摘要 Background: Risk factors for atherosclerosis such as hypertension, type 2 diabetes, obesity and dyslipidemia affect endothelial function and stimulate adhesion molecules expression. The aim of the study was to examine endothelial activation in type 2 diabetes and hypertension as indicated by adhesion molecule levels and further to investigate whether the coexistence of the above conditions has a different effect. Methods: Serum levels of soluble E-selectin, ICAM-1 and VCAM-1 were measured in 17 hypertensive type 2 diabetic patients(DM-HY), 32 normotensive type 2 diabetic patients(DM), 11 hypertensive nondiabetic patients(HY) and 15 healthy subjects. Results: In diabetic patients(either DM-HY or DM), soluble E-selectin levels were significantly increased compared to healthy subjects(p< 0.001). In HY patients, both sE-selectin(66.44±71.59 vs. 29.42±15.56 ng/ml, p=0.033) and sVCAM-1(1529±433.33 vs. 1027±243.56 ng/ml, p=0.03) levels were found significantly higher compared to healthy subjects(p< 0.05). The coexistence of diabetes and hypertension(DM-HY) did not have an additive effect on circulating adhesion molecules levels compared with the levels observed in either diabetes or hypertension. Systolic and diastolic blood pressure(BP) were independent factors correlated respectively with sE-selectin and sVCAM-1 levels(R=0.454, p=0.034 and R=0.578, p=0.005) in nondiabetic subjects(hypertensive and normotensive). Conclusions: Type 2 diabetes mellitus and hypertension induce endothelial activation as indicated by elevated levels of soluble adhesion molecules. This effect is not different when comorbidity is present. Background: Risk factors for atherosclerosis such as hypertension, type 2 diabetes, obesity and dyslipidemia affect endothelial function and stimulate adhesion molecules expression. The aim of the study was to examine endothelial activation in type 2 diabetes and hypertension as indicated by adhesion molecule levels and further to investigate whether the coexistence of the above conditions has a different effect. Methods: Serum levels of soluble E-selectin, ICAM-1 and VCAM-1 were measured in 17 hypertensive type 2 diabetic patients(DM-HY), 32 normotensive type 2 diabetic patients(DM), 11 hypertensive nondiabetic patients(HY) and 15 healthy subjects. Results: In diabetic patients(either DM-HY or DM), soluble E-selectin levels were significantly increased compared to healthy subjects(p< 0.001). In HY patients, both sE-selectin(66.44±71.59 vs. 29.42±15.56 ng/ml, p=0.033) and sVCAM-1(1529±433.33 vs. 1027±243.56 ng/ml, p=0.03) levels were found significantly higher compared to healthy subjects(p< 0.05). The coexistence of diabetes and hypertension(DM-HY) did not have an additive effect on circulating adhesion molecules levels compared with the levels observed in either diabetes or hypertension. Systolic and diastolic blood pressure(BP) were independent factors correlated respectively with sE-selectin and sVCAM-1 levels(R=0.454, p=0.034 and R=0.578, p=0.005) in nondiabetic subjects(hypertensive and normotensive). Conclusions: Type 2 diabetes mellitus and hypertension induce endothelial activation as indicated by elevated levels of soluble adhesion molecules. This effect is not different when comorbidity is present.

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