目的探讨2型糖尿病并发下肢血管斑块形成时黏附分子可溶性E-选择素(sE-selectin)和可溶性细胞间黏附分子-1(sICAM-1)的水平及2型糖尿病并发下肢血管斑块形成的影响因素。方法采用酶联免疫吸附法检测51例2型糖尿病患者及20例年龄和性别...目的探讨2型糖尿病并发下肢血管斑块形成时黏附分子可溶性E-选择素(sE-selectin)和可溶性细胞间黏附分子-1(sICAM-1)的水平及2型糖尿病并发下肢血管斑块形成的影响因素。方法采用酶联免疫吸附法检测51例2型糖尿病患者及20例年龄和性别比例相匹配的非糖尿病对照组血浆sE-selectin和sICAM-1的水平。再从病例组选择性别比例、病程和年龄相匹配的无下肢血管斑块形成者16例(组1)、有下肢血管斑块形成者17例(组2)及对照组中选择性别比例和年龄相匹配者17例(组3),比较三组之间血sE-selectin和sICAM-1的水平。采用Logistic多因素回归分析2型糖尿病并发下肢血管斑块形成的影响因素。结果病例组空腹血糖(FPG)和餐后2小时血糖(2 h PG)、胰岛素抵抗指数(HOMA-IR)、血sE-selectin和sICAM-1均高于对照组,差别有统计学意义(均P<0.01)。组1 sE-selectin和sICAM-1与组2比较,差别无统计学意义(P>0.05)。组1和组2血糖高于组3(P<0.01);组3空腹胰岛素(FINS)水平依次高于组2和组1,但与组1比较,差别有统计学意义(P<0.05);组1sE-selectin高于组3(P<0.01);组1和组2 sICAM-1高于组3(均P<0.05)。Logistic多因素回归分析结果显示,年龄(OR=1.214,95%CI:1.087～1.366)、收缩压(OR=1.492,95%CI:1.291～1.725)、低密度脂蛋白胆固醇(LDL-C,OR=1.045,95%CI:1.214～1.993)为糖尿病下肢血管病变危险因素。结论2型糖尿病患者血sE-selectin与sICAM-1水平高于非糖尿病者,说明糖尿病患者存在内皮细胞的活化;2型糖尿病患者无论有无下肢血管斑块形成,均有内皮细胞功能紊乱,黏附分子的作用在下肢血管斑块形成前可能更为活跃;年龄、收缩压和LDL-C为糖尿病下肢血管病变危险因素。展开更多
Background: Inflammation has been reported to be a major contributing factor to many cardiovascular events. In the present study, we aimed to evaluate plasma soluble adhesion molecules; intercellular adhesion molecule...Background: Inflammation has been reported to be a major contributing factor to many cardiovascular events. In the present study, we aimed to evaluate plasma soluble adhesion molecules; intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1) and E-selectin as possible indicators of endothelial activation or inflammation in patients with slow coronary flow. Method: Study population included 17 patients with angiographically proven normal coronary arteries and slow coronary flow in all three coronary vessels(group I, 11 male, 6 female, mean age=48± 9 years), and 20 subjects with angiographically proven normal coronary arteries without associated slow coronary flow(group II, 11 male, 9 female, mean age=50± 8 years). Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction frame count(TIMI frame count). All patients in group I had TIMI frame counts greater than two standard deviation above those of control subjects(group II) and, therefore, were accepted as exhibiting slow coronary flow. Serum levels of ICAM-1, VCAM-1, and E-selectin were measured in all patients and control subjects using commercially available ELISA kits. Results: Serum ICAM-1, VCAM-1, and E-selectin levels of patients with slow coronary flow were found to be significantly higher than those of control subjects with normal coronary flow(ICAM-1: 545± 198 ng/ml vs. 242± 113 ng/ml respectively, p< 0.001, VCAM-1: 2040± 634 ng/ml vs. 918± 336 ng/ml respectively, p< 0.001, E-selectin: 67± 9 ng/ml vs. 52± 8 ng/ml respectively, p< 0.001). Average TIMI frame count was detected to be significantly correlated with plasma soluble ICAM-1(r=0.550, p< 0.001), VCAM-1(r=0.569, p< 0.001) and E-selectin(r=0.443, p=0.006). Conclusion: Increased levels of soluble adhesion molecules in patients with slow coronary flow may be an indicator of endothelial activation and inflammation and are likely to be in the causal pathway leading to slow coronary flow.展开更多
Objective: Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SA...Objective: Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of BA. Study Design: Serum ICAM-1 (sICAM-1), serum vascular cell adhesion mol-ecule (sVCAM-1), and serum E selectin (sE-selectin) were measured by enzyme-linked immunosorbent assay in infants with BA at the time of portoenterostomy and stratified by outcome. Results are quoted as medians (range). Binary logistic regression analysis and actuarial survival curves were used to investigate the relationship of SAM profile to outcome. Significance was assumed at P values of ≤ .05. Results: Sixty-one infants with BA were treated between 1996 and 2002 and at follow-up; 39 of these were alive and jaundice-free (good outcome, n=39); 21 had been transplanted, and 1 died (poor outcome, n=22). Preoperative values for sICAM-1 were 1233 (400-2000) ng/mL; sVCAM-1, 1204(517-1921) ng/mL; and sE-selectin, 71(26-192) ng/mL. sVCAM-1(P< .0001)-and sICAM-1(P < .0001) significantly increased compared with normal control infants, although sE-selectin did not (P = .17). There was a significant correlation of age at surgery with sICAM-1 (r = 0.33, P = .01) but not with sVCAM-1 (r = 0.16, P = .23) or sE-selectin (r = 0.05, P = .70). Binary logistic regression analysis showed that the variables, sICAM-1, sE-selectin, or age at surgery, were not significant predictors of outcome, although sVCAM-1 approached significance (P = .069). A cutoff value for sVCAM-1 of 1380 ng/mL was defined by receiver operating characteristic curve analysis, and the cohort of patients with sVCAM-1 (>1380 ng/mL) showed a significantly worse actuarial survival (P = .05). Conclusion: Levels of sICAM-1 and sVCAM-1 are grossly elevated in BA, whereas sE-selectin levels are normal. Only sVCAM-1 levels have prognostic significance. SAM profiling has the potential to monitor the inflammatory process of BA and may guide more novel forms of pharmacological intervention or immunomodulation.展开更多
文摘目的探讨2型糖尿病并发下肢血管斑块形成时黏附分子可溶性E-选择素(sE-selectin)和可溶性细胞间黏附分子-1(sICAM-1)的水平及2型糖尿病并发下肢血管斑块形成的影响因素。方法采用酶联免疫吸附法检测51例2型糖尿病患者及20例年龄和性别比例相匹配的非糖尿病对照组血浆sE-selectin和sICAM-1的水平。再从病例组选择性别比例、病程和年龄相匹配的无下肢血管斑块形成者16例(组1)、有下肢血管斑块形成者17例(组2)及对照组中选择性别比例和年龄相匹配者17例(组3),比较三组之间血sE-selectin和sICAM-1的水平。采用Logistic多因素回归分析2型糖尿病并发下肢血管斑块形成的影响因素。结果病例组空腹血糖(FPG)和餐后2小时血糖(2 h PG)、胰岛素抵抗指数(HOMA-IR)、血sE-selectin和sICAM-1均高于对照组,差别有统计学意义(均P<0.01)。组1 sE-selectin和sICAM-1与组2比较,差别无统计学意义(P>0.05)。组1和组2血糖高于组3(P<0.01);组3空腹胰岛素(FINS)水平依次高于组2和组1,但与组1比较,差别有统计学意义(P<0.05);组1sE-selectin高于组3(P<0.01);组1和组2 sICAM-1高于组3(均P<0.05)。Logistic多因素回归分析结果显示,年龄(OR=1.214,95%CI:1.087～1.366)、收缩压(OR=1.492,95%CI:1.291～1.725)、低密度脂蛋白胆固醇(LDL-C,OR=1.045,95%CI:1.214～1.993)为糖尿病下肢血管病变危险因素。结论2型糖尿病患者血sE-selectin与sICAM-1水平高于非糖尿病者,说明糖尿病患者存在内皮细胞的活化;2型糖尿病患者无论有无下肢血管斑块形成,均有内皮细胞功能紊乱,黏附分子的作用在下肢血管斑块形成前可能更为活跃;年龄、收缩压和LDL-C为糖尿病下肢血管病变危险因素。
文摘Background: Inflammation has been reported to be a major contributing factor to many cardiovascular events. In the present study, we aimed to evaluate plasma soluble adhesion molecules; intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1) and E-selectin as possible indicators of endothelial activation or inflammation in patients with slow coronary flow. Method: Study population included 17 patients with angiographically proven normal coronary arteries and slow coronary flow in all three coronary vessels(group I, 11 male, 6 female, mean age=48± 9 years), and 20 subjects with angiographically proven normal coronary arteries without associated slow coronary flow(group II, 11 male, 9 female, mean age=50± 8 years). Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction frame count(TIMI frame count). All patients in group I had TIMI frame counts greater than two standard deviation above those of control subjects(group II) and, therefore, were accepted as exhibiting slow coronary flow. Serum levels of ICAM-1, VCAM-1, and E-selectin were measured in all patients and control subjects using commercially available ELISA kits. Results: Serum ICAM-1, VCAM-1, and E-selectin levels of patients with slow coronary flow were found to be significantly higher than those of control subjects with normal coronary flow(ICAM-1: 545± 198 ng/ml vs. 242± 113 ng/ml respectively, p< 0.001, VCAM-1: 2040± 634 ng/ml vs. 918± 336 ng/ml respectively, p< 0.001, E-selectin: 67± 9 ng/ml vs. 52± 8 ng/ml respectively, p< 0.001). Average TIMI frame count was detected to be significantly correlated with plasma soluble ICAM-1(r=0.550, p< 0.001), VCAM-1(r=0.569, p< 0.001) and E-selectin(r=0.443, p=0.006). Conclusion: Increased levels of soluble adhesion molecules in patients with slow coronary flow may be an indicator of endothelial activation and inflammation and are likely to be in the causal pathway leading to slow coronary flow.
文摘Objective: Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of BA. Study Design: Serum ICAM-1 (sICAM-1), serum vascular cell adhesion mol-ecule (sVCAM-1), and serum E selectin (sE-selectin) were measured by enzyme-linked immunosorbent assay in infants with BA at the time of portoenterostomy and stratified by outcome. Results are quoted as medians (range). Binary logistic regression analysis and actuarial survival curves were used to investigate the relationship of SAM profile to outcome. Significance was assumed at P values of ≤ .05. Results: Sixty-one infants with BA were treated between 1996 and 2002 and at follow-up; 39 of these were alive and jaundice-free (good outcome, n=39); 21 had been transplanted, and 1 died (poor outcome, n=22). Preoperative values for sICAM-1 were 1233 (400-2000) ng/mL; sVCAM-1, 1204(517-1921) ng/mL; and sE-selectin, 71(26-192) ng/mL. sVCAM-1(P< .0001)-and sICAM-1(P < .0001) significantly increased compared with normal control infants, although sE-selectin did not (P = .17). There was a significant correlation of age at surgery with sICAM-1 (r = 0.33, P = .01) but not with sVCAM-1 (r = 0.16, P = .23) or sE-selectin (r = 0.05, P = .70). Binary logistic regression analysis showed that the variables, sICAM-1, sE-selectin, or age at surgery, were not significant predictors of outcome, although sVCAM-1 approached significance (P = .069). A cutoff value for sVCAM-1 of 1380 ng/mL was defined by receiver operating characteristic curve analysis, and the cohort of patients with sVCAM-1 (>1380 ng/mL) showed a significantly worse actuarial survival (P = .05). Conclusion: Levels of sICAM-1 and sVCAM-1 are grossly elevated in BA, whereas sE-selectin levels are normal. Only sVCAM-1 levels have prognostic significance. SAM profiling has the potential to monitor the inflammatory process of BA and may guide more novel forms of pharmacological intervention or immunomodulation.
