Levels of circulating soluble cell adhesion molecules in diabetics and in impaired glucose tolerance patients: correlation to stiffness index beta of the common carotid and femoral arteries

ABSTRACT

The current work was conducted to study the possible relationship between endothelial activation as assessed by the level of circulating soluble VCAM-1, ICAM-1, and E-selectin concentrations and atherosclerotic disease as assessed by the stiffness index 13 of the common carotid and femoral arteries in type 2 diabetic patients and patients with impaired glucose tolerance and the correlation of stiffness index beta of the common carotid artery and femoral artery with the degree of insulin resistance. Subjects and This study entailed 20 patients with type 2 diabetes meilitus, representing group I [GI], and 20 patients with impaired glucose tolerance, representing group II [GII] and 20 healthy subjects of matched age and sex as a control group, III [GIII]. All subjects were subjected to complete history taking and thorough clinical examination including body mass index [BMI]. Routine Laboratory investigations included oral glucose tolerance test [OGTT], glycosylated hemoglobin [HbA[1c]], serum uric acid, serum triglycerides, total serum cholesterol, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], as well as liver and renal function tests were carried out by using standard commercial methods. The level of urinary microalbumin in GI, and insulin sensitivity assessment through OGTT, in all groups were carried out. Serum levels of the circulating adhesion molecules ICAM-1, VCAM-1 and E-selectin were measured in GI, II, and III by an enzyme-linked immunosorbent assay. All subjects were subjected also to radiological measurement of stiffness indexes beta of the common carotid and femoral arteries by high-resolution ultrasonography. sVCAM was found to be 681.2 +/- 81.8, 551.7 +/- 33.5, 453.4 +/- 28.4 ng/ml in GI, GII, and GIII, respectively. sICAM was found to be 339.4 +/- 18.8, 301 +/- 19.3, 197.8 +/- 9.2 ng/ml in GI, GII, and GIII, respectively. E-selectin was found to be 90.4 +/- 5.7, 69.8 +/- 6.8, 51.1 +/- 6.6 ng/ml in GI, GII, and GIII, respectively. Using LSD, sVCAM, sICAM, and E-selectin were found to be significantly increased in GI when compared to GII and GIII and to be significantly increased in GII when compared to Gill. Concerning stiffness index of carotid artery, it was found to be 28.7 +/- 8.3, 14.7 +/- 1.4, 12.1 +/- 1.6 in GI, GII, and GIII respectively. Using LSD, stiffness index of carotid artery was found to be significantly increased in GI when compared to GII and controls. With reference to stiffness index of femoral artery, it was found to be 30.3 +/- 7.1, 15.4 +/- 1.4, 12.7 +/- 2.4 in GI, GII, and GIII, respectively. Using LSD, stiffness index of the femoral artery, it was found to be significantly increased in GI when compared to GII and controls. It could be concluded that cAMs can be used as a marker of the stiffness index beta of both common carotid and femoral arteries due to the noted significant positive association. Stiffness index beta of both common carotid and femorai arteries are exacerbated in type 2 diabetic patients than in patients with impaired glucose tolerance and controls. The stiffness index beta of both common carotid and femorai arteries are associated with insulin resistance in type 2 diabetes meilitus. Further prospective studies should be carried to ascertain whether insulin resistance may induce the early changes of atherosclerosis in diabetes