2型糖尿病患者血糖波动与颈动脉内膜中层厚度相关性研究

【目的】探讨2型糖尿病（T2DM）患者血糖（BG）波动与颈动脉内膜中层厚度（IMT）的相关性。【方法】选取本院长期随访的T2DM患者,根据彩超测定结果将病例分为颈动脉IMT增厚组（A组,IMT≥0．9mm）和颈动脉IMT正常组（B组,IMT〈0．9mm）,测量各组糖化血红蛋白（HbAlc）、空腹胰岛素（FINs）及餐后2h胰岛素（2hiNS）、空腹及餐后2hC肽、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）。采用自我血糖监测（SMBG）方式记录检测结果,共24周。【结果】两组患者空腹血糖（FBG）无统计学差异（P〉0．05）,但三餐后血糖（PBG）水平、空腹平均血糖标准差（SDBG）、餐后SDBG均有统计学差异（P〈0．05）。线性相关分析显示,IMT（转换后）与年龄、TC、TG、SBP、DBP、FBG、早餐后2hPBG、午餐后2hPBG、晚餐后午餐后2hPBG、空腹SDBG、餐后SDBG的线性相关关系显著（P〈0．05）,与性别、病程（转换后）、BMI、HbAlc（转换后）、HDL、LDL、FINS、2hFINS、空腹C肽、餐后2hC肽的相关关系不显著（P〉0．05）。偏相关分析显示IMT（转换后）与TC、TG、SBP、FBG、早餐后2hPBG、午餐后2hPBG、晚餐后午餐后2hPBG、空腹sDBG、餐后sDBG的相关关系显著（P〈0．05）,与DBP的相关关系不显著（P〉0．05）。以IMT（转换后）为因变量,多元逐步回归分析显示餐后sDBG、TC依次进入方程。【结论】血糖波动,尤其是餐后血糖波动与T2DM患者颈动脉IMT厚度密切相关。     

2型糖尿病患者颈动脉粥样硬化与亚临床炎症因子的关系

[目的]观察2型糖尿病(T2DM)患者颈动脉粥样硬化与慢性亚临床炎症因子的关系,探讨炎症反应对糖尿病大血管病变的影响.[方法]检测136例T2DM患者双侧颈总动脉内-中膜厚度(IMT),根据超声检查结果,分为颈动脉粥样硬化组(A组,51例)和对照组(C组,85例),比较两组空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbAlc)、甘油三酯(TG)、总胆固醇(TC),低密度脂蛋白(LDL)、超敏C反应蛋白(hsCRP)、外周血白细胞(WBC)计数及体重指数(BMI)、胰岛素抵抗指数(HOMA-IR).[结果]A组与C组比较BMI、HbAlc、HOMA-IR、TG、LDL以及hsCRP,WBC均升高,且差异均具有显著性(P＜0.05或P＜0.01).相关分析显示IMT与BMI、HbAlc、HOMA-IR、LDL、hsCRP、WBC呈正相关.[结论]慢性亚临床炎症参与T2DM大血管病变的发生及发展,炎症因子水平可为预测和评估病情提供依据.     

瑞舒伐他汀对2型糖尿病患者颈动脉粥样硬化的疗效分析

目的观察瑞舒伐他汀对2型糖尿病患者颈动脉粥样硬化的治疗效果。方法将2型糖尿病颈动脉硬化患者110例分为两组,对照组55例采取常规治疗,观察组55例在对照组基础上外加瑞舒伐他汀,对比两组患者的临床疗效。结果观察组55例患者中,显效32例,有效20例,无效2例,总有效率为96.36%,与对照组患者相比具有显著性差异,P<0.05。结论瑞舒伐他汀治疗2型糖尿病颈动脉粥样硬化安全、有效,值得推广。     

超声心动图评价2型糖尿病患者的左心室重构和功能损害

目的联合运用常规超声心动图和三维斑点追踪成像技术评价不同左室构型的2型糖尿病患者心脏功能的损害情况。方法 78例2型糖尿病患者(LVEF≥55%)分为左室正常构型组(34例)和左室重构组(44例)。40例年龄、性别匹配且无左室重构的健康体检者作为对照组。采集左心室全容积图像分析,计算射血分数(EF)、整体纵向应变(GLS)、圆周应变(GCS)、面积应变(GAS)和径向应变(GRS)。结果糖尿病左室正常构型组仅有GLS显著低于对照组(P<0.05);而糖尿病左室重构组GLS、GCS、GAS和GRS均显著低于对照组和糖尿病左室正常构型组(all P<0.01)。糖尿病左室肥厚组(向心性和离心性)的GLS、GAS和GRS显著低于糖尿病左室向心性重构组(all P<0.05)。结论常规超声心动图和三维斑点追踪成像联合运用可以检测出2型糖尿病患者的左心室代谢性重构和伴随的功能损害。     

2型糖尿病颈动脉内膜中层厚度与尿微量白蛋白水平相关性研究

目的 探讨2型糖尿病患者大血管病变与尿微量白蛋白( mAlb)水平的关系.方法 将我院2010年1～5月收治的2型糖尿病118例,根据有无颈动脉内膜中层厚度(IMT)增厚分为IMT正常组60例,IMT增厚组52例;选取同期健康体检58例为正常对照组.分别测定3组mAlb,颈动脉超声检测IMT,并分析mAlb与IMT的相关性.结果ITM正常组mAlb阳性率为70.0％,ITM增厚组mAlb阳性率为84.5％,均高于正常对照组,差异有统计学意义(P＜0.05).ITM增厚组mAlb水平及阳性率高于ITM正常组,且mAlb水平与IMT呈正相关(r=0.215,P＜0.05).结论2型糖尿病患者的IMT与mAlb水平密切相关,mAlb水平可用于糖尿病大血管病变早期风险的预测.     

颈动脉内膜切除术治疗颅外颈内动脉重度狭窄近远期疗效

目的 :评价颈动脉内膜切除术治疗颅外颈内动脉重度狭窄近远期疗效。方法 :1993年 5月～ 2 0 0 0年 6月 ,共 2 0例接受2 1次颈动脉内膜切除术。男性 19例 ,女性 1例 ,年龄 47～ 76岁 ,平均 6 4± 9岁。其中缺血性中风患者 7例 ,一过性脑缺血者11例 ,无神经症状者 2例。所有患者均行术前颈动脉Duplex超声检查 ,19例同时行DSA检查 ,18例行MRA检查。狭窄度测定方法同NASCET。 2 1侧手术的颈内动脉中 ,19侧狭窄≥ 70 % ,2侧狭窄 6 0 %～ 6 9%伴斑块溃疡。采取颈丛麻醉 ,术中选择性地应用转流管和补片缝合。术后定期行超声检查和随访。结果 :术后 30d内无死亡和中风。围手术期有 1例TIA和 2例术后颅神经损伤。 2 0例随访 1～ 6 3个月 ,平均 31± 2 0个月。术后 2年生存率和中风发生率为 92 .3 %和 0 ,5年生存率和中风发生率为 79.1%和 12 .5 %。 2例随访超声检查发现手术侧颈内动脉 5 0 %～ 6 0 %的再狭窄。结论 :颈动脉内膜切除术治疗颅外颈内动脉重度狭窄有满意的围手术期结果和预防中风的远期疗效     

2型糖尿病患者血糖、血脂与轻度认知功能损害的关系

【目的】探讨2型糖尿病（T2DM）患者轻度认知功能损害（MCI）的相关因素。【方法】采用蒙特利尔认知评估（MoCA）北京版量表作为认知功能的主要测评工具,选取T2DM合并MCI患者58例为研究对象,T2DM无MCI患者60例为对照。空腹静脉采血。测定入选病例的糖化血红蛋白（HbAlc）、血脂、肝肾功能。【结果】与对照组比较,MCI组非高密度脂蛋白胆固醇（NHDL—C）、胆固醇（TC）、甘油三酯（TG）、HbAIc水平明显升高（P〈0．01）,高密度脂蛋白胆固醇（HDL-C）水平降低（P〈0．01）,低密度脂蛋白胆固醇（LDL—C）、丙氨酸转氨酶（ALT）、肌酐（Cr）差异无统计学意义。两组糖尿病（DM）病程、体重指数（BMI）差异具有统计学意义（均P〈0．05）。【结论】NHDL—C是DM并发MCI危险性评估的一项有用的指标。T2DM患者血糖控制不良、血脂紊乱等因素与认知功能损害相关。     

Relationships Between Daily Acute Glucose Fluctuations and Cognitive Performance Among Aged Type 2 Diabetic Patients

OBJECTIVE

The mean amplitude of glycemic excursions (MAGE) is a significant determinant of overall metabolic control as well as increased risk for diabetes complications. Older individuals with type 2 diabetes are more likely to have moderate cognitive deficits and structural changes in brain tissue. Considering that poor metabolic control is considered a deranging factor for cognitive performance in diabetic patients, we evaluated whether the contributions of MAGE to cognitive status in older patients with type 2 diabetes were independent from the main markers of glycemic control, such as sustained chronic hyperglycemia (A1C), postprandial glycemia (PPG), and fasting plasma glucose (FPG).

RESEARCH DESIGN AND METHODS

In 121 older patients with type 2 diabetes, 48-h continuous subcutaneous glucose monitoring (CSGM) were assessed. MAGE and PPG were evaluated during CSGM. The relationship of MAGE to performance on cognitive tests was assessed, with adjustment for age, glycemic control markers, and other determinants of cognitive status. The cognitive tests were a composite score of executive and attention functioning and the Mini Mental Status Examination (MMSE).

RESULTS

MAGE was significantly correlated with MMSE (r = 0.83; P < 0.001) and with cognition composite score (r = 0.68; P < 0.001). Moreover, MAGE was associated with the MMSE (P < 0.001) and cognition composite score (P < 0.001) independently of age, sex, BMI, waist-to-hip (WHR) ratio, drug intake, physical activity, mean arterial blood pressure, FPG, PPG, and A1C.

CONCLUSIONS

MAGE during a daily period was associated with an impairment of cognitive functioning independent of A1C, FPG, and PPG. The present data suggest that interventional trials in older patients with type 2 diabetes should target not only A1C, PPG, and FPG but also daily acute glucose swings.It is widely known that older individuals with type 2 diabetes are more likely to experience cognitive decline than those without type 2 diabetes (1). The underlying mechanisms, however, are still unclear, but emerging evidence suggests that a relationship between measures of glucose control and cognitive function exists (2). For instance, a cross-sectional analysis in 378 high-functioning individuals with diabetes showed that higher A1C but not fasting plasma glucose (FPG) levels were consistently associated with lower scores on two cognitive tests (3). Further evidence comes from studies using other indexes of dysglycemia, such as postprandial glycemia (PPG) and acute hyperglycemia (4,5). Therefore, despite the fact that several studies have investigated and compared the roles of the different glycemic indexes participating in diabetic cognitive disorders, an accurate assessment of their respective contributions is still difficult. Considering that the brain is dependent on an appropriate supply of glucose as its principal energy source, one cannot rule out the possibility that plasma glucose instability over 24 h may affect cognitive functioning. From a more practical point of view, exposure to glycemic disorders can be described as a function of two components: 1) the duration and magnitude of chronic sustained hyperglycemia and 2) the acute fluctuations of glucose over a daily period (6,7). The first component was integrated by A1C, which depends on both interprandial and postprandial hyperglycemia, the percentage of each contributor being modulated by the degree of diabetic control (8). The acute fluctuations of glucose around a mean value is more difficult to assess, but the recent development of devices that allow continuous glucose monitoring on an ambulatory basis certainly represents a new approach for studying the influence of acute blood glucose fluctuations in real life (9). By applying this technology, we have attempted to gain further insight into the respective role of both sustained chronic hyperglycemia and acute glucose fluctuations over a daily period on global cognitive functioning as well as executive and attention functioning neuropsychological tests.     

基质金属蛋白酶-9及胰岛素抵抗与2型糖尿病颈动脉粥样硬化的相关性研究

目的研究2型糖尿病患者基质金属蛋白酶-9（MMP-9）及胰岛素抵抗与颈动脉粥样硬化的关系。方法采用ELISA法分别检测正常人25例（对照组）、按体重指数（BMI）分成糖尿病非肥胖组26例和糖尿病肥胖组34例患者的血清MMP-9水平和胰岛素抵抗指数（HOMA-IR）等生化指标，应用彩色多普勒超声测量颈动脉内膜中层厚度（IMT）进行相关分析。结果糖尿病2组的HbAlc、FPG、FINS、HOMAIR、MMP-9、IMT的指标较对照组明显增高（P〈0．05或0．01），糖尿病肥胖组的FINS、HOMAIR、MMP-9的水平均高于非肥胖组（P〈0．05或0．01），而HbAlc、FPG、IMT相比较没有显著性差异（P〉0．05）。相关分析表明糖尿病2组血清MMP-9和HOMA-IR指标与IMT呈正相关。结论2型糖尿病患者颈动脉粥样硬化病变严重程度与血清MMP-9和HOMA-IR增高有密切的关系。     

2型糖尿病认知功能障碍影响因素及发病机制研究进展

近年来,糖尿病引起的中枢神经系统损害日益受到人们的重视,2型糖尿病患者存在认知功能障碍.本文从影响因素、发病机制等方面,就近年来对2型糖尿病患者认知功能障碍的研究进行了综述.     

基质金属蛋白酶-9及胰岛素抵抗与2型糖尿病颈动脉粥样硬化的相关性研究

目的研究2型糖尿病患者基质金属蛋白酶-9(MMP-9)及胰岛素抵抗与颈动脉粥样硬化的关系。方法采用ELISA法分别检测正常人25例(对照组)、按体重指数(BMI)分成糖尿病非肥胖组26例和糖尿病肥胖组34例患者的血清MMP-9水平和胰岛素抵抗指数(HOMA-IR)等生化指标,应用彩色多普勒超声测量颈动脉内膜中层厚度(IMT)进行相关分析。结果糖尿病2组的HbA1c、FPG、FINS、HOMA IR、MMP-9、IMT的指标较对照组明显增高(P<0.05或0.01),糖尿病肥胖组的FINS、HOMA IR、MMP-9的水平均高于非肥胖组(P<0.05或0.01),而HbA1c、FPG、IMT相比较没有显著性差异(P>0.05)。相关分析表明糖尿病2组血清MMP-9和HOMA-IR指标与IMT呈正相关。结论2型糖尿病患者颈动脉粥样硬化病变严重程度与血清MMP-9和HOMA-IR增高有密切的关系。     

2型糖尿病病人血清sICAM-1、sVCAM-1与颈动脉粥样硬化的相关性研究

目的探讨2型糖尿病（T2DM）病人血清细胞间黏附分子1（sICAM-1）和血管细胞黏附分子1（sVCAM-1）与颈动脉粥样硬化的关系。方法酶联免疫吸附（ELISA）法检测120例T2DM病人（T2DM组）,根据超声颈动脉内中膜厚度（IMT）检查结果将120例T2DM病人分为3个亚组：IMT正常组40例、IMT增厚组30例、IMT斑块组50例（又根据超声IMT检查结果分为2小亚组：稳定斑块组36例、不稳定斑块组14例）与58例健康体检者（对照组）血清sICAM-1、sVCAM-1水平,并进行生化指标检测。结果糖尿病组血清sICAM-1、sVCAM-1水平均显著高于对照组（均P〈0．05）。IMT增厚组、IMT斑块组血清sICAM-1、sVCAM-1水平均显著高于IMT正常组（均P〈0．05）,不稳定斑块组显著高于稳定斑块组（P〈0．05）。糖尿病组血清sICAM-1、sVCAM-1水平与三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（HbAlc）、高敏C反应蛋白（Hs—CRP）均呈正相关（r=0．670、0．665、0．666、0．702、0．678、0．675、0．686、0．704,均P〈0．01）。结论T2DM病人血清sICAM—1、sVCAM-1水平与颈动脉粥样硬化程度及斑块稳定性有关,其升高与慢性高血糖、脂代谢紊乱及炎症反应相关。     

Comparison of Carotid Artery Stenting and Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis: A Single Center Study

Introduction

Carotid artery stenting (CAS) is believed to be an alternative to carotid endarterectomy (CEA); however, recent studies have demonstrated an increase of complications with stenting that does not reflect our experience. We thus wanted to compare the periprocedural and 1-year follow-up outcomes of CAS with those of CEA among patients with symptomatic extracranial carotid stenosis in a population from eastern Turkey.

Methods

The hospital records of all patients who underwent carotid artery revascularization were retrospectively reviewed. Patients were divided into two groups based on the type of carotid revascularization performed, namely CEA or CAS. Comparisons were made with respect to 30-day and 1-year outcomes of transient ischemic attack (TIA), myocardial infarction (MI), stroke, and all-cause death rates. Composite endpoints for both groups were also analyzed.

Results

Thirty-two CEA and 33 CAS procedures were performed for symptomatic occlusive carotid disease. Baseline characteristics were similar between both groups except for the incidence of diabetes mellitus. No significant differences were found with respect to 30-day mortality, MI, and neurologic morbidity endpoints for CEA and CAS procedures. In the postprocedural 1-year follow-up, only TIA was observed to be significantly higher in the CAS group; the other endpoints did not differ significantly. One-year composite endpoints did not differ between both groups (log-rank P = 0.300).

Conclusion

In our trial of patients with symptomatic carotid artery stenosis, no significant difference could be shown in periprocedural outcomes, postprocedural outcomes except TIA, and in composite endpoints between the CEA and CAS groups. CAS is a safe and efficacious alternative for the treatment of symptomatic carotid artery stenosis.     

2型糖尿病患者中性粒细胞与淋巴细胞比值与糖尿病视网膜病变的相关性

【目的】探讨2型糖尿病（T2DM ）患者中性粒细胞与淋巴细胞比值（NLR）与糖尿病视网膜病变（DR）的相关性。【方法】选取T2DM患者202例,其中单纯T2DM患者102例（DM组）,合并有DR的T2DM患者100例（DR组）,另外选择50名健康体检者为正常对照（NC组）。检测各组白细胞、中性粒细胞、淋巴细胞计数,空腹血糖（FPG）、尿酸及血脂并比较;计算体质量指数（BMI）、NLR。【结果】DR组、DM 组白细胞计数、NLR均显著高于NC组,且DR组NLR高于DM组（均 P＜0．05）。Logistic回归分析显示NLR、病程、收缩压和尿酸是T2DM患者发生DR的危险因素。【结论】NLR与T2DM患者DR的发生密切相关,NLR升高是T2DM患者DR危险因素。     

老年2型糖尿病患者术后认知功能障碍与术前糖化血红蛋白水平的关系

目的：探讨老年2型糖尿病（T2DM）患者术后认知功能障碍（POCD）与术前糖化血红蛋白（HbA1c）的相关性。方法选择82例全身麻醉下行非心脏手术的老年 T2DM患者作为研究对象,术后发生 POCD 37例（A组）,未发生 POCD 45例（B组）,两组采用相同的麻醉方法,比较两组术前 HbA1c、空腹血糖水平,并比较不同 HbA1c水平患者术后POCD发生率。结果两组患者性别组成、年龄、体重指数、术前 MMSE评分、并发高血压率、手术时间及术中出血量差异无统计学意义,两组患者术前空腹血糖分别为7.1±2.6和6.7±1.8 mmol/L,差异无统计学意义（t＝0.821,P＝0.424）,两组术前HbA1c分别为（7.2±1.3）％和（6.3±1.0）％,A组高于 B组,差异有统计学意义（t＝3.543,P＝0.001）;AH 组 POCD发生率为58.1％（25/43）,AL组POCD发生率为30.8％（12/39）,AH 组高于 AL 组,差异有统计学意义（χ2＝5.131,P＝0.024）。结论术前 HbA1c测定对于老年T2DM患者术后POCD的发生有一定预测意义,术前将 HbA1c值控制在较低水平,有利于降低老年T2DM患者术后POCD的发生。     

脑肿瘤患者术后认知功能障碍

随着对脑肿瘤治疗方案研究的日益深入以及患者对生存质量要求的不断提高,作为术后常见并发症之一,术后认知功能障碍逐渐受到临床关注.目前认为,包括炎症因子、活性氧、高迁移率族蛋白B1等在内的细胞因子表达异常是其发生的分子机制.由于认知功能的抽象性,为了更好地对术后认知功能障碍进行评定,临床设计了一系列量表,但不同患者如何选用...     

脑肿瘤患者术后认知功能障碍

随着对脑肿瘤治疗方案研究的日益深入以及患者对生存质量要求的不断提高,作为术后常见并发症之一,术后认知功能障碍逐渐受到临床关注。目前认为,包括炎症因子、活性氧、高迁移率族蛋白B1等在内的细胞因子表达异常是其发生的分子机制。由于认知功能的抽象性,为了更好地对术后认知功能障碍进行评定,临床设计了一系列量表,但不同患者如何选用适宜的量表尚无定论。关于术后认知功能障碍的治疗,主要包括药物治疗和非药物治疗,但目前尚处于研究的初级阶段,缺乏临床指南。本文对脑肿瘤患者术后认知功能障碍的原因、分子机制、评估方式以及治疗方案进行了总结,以期为临床提供借鉴。     

Human Leukocyte/Endothelial Cell Interactions and Mitochondrial Dysfunction in Type 2 Diabetic Patients and Their Association With Silent Myocardial Ischemia

OBJECTIVE

Diabetes is associated with oxidative stress and increased mortality, but a possible correlation between leukocyte-endothelium interactions, oxidative stress, and silent myocardial ischemia (SMI) is yet to be confirmed.

RESEARCH DESIGN AND METHODS

Mitochondrial dysfunction and interactions between leukocytes and human umbilical vein endothelial cells were evaluated in 200 type 2 diabetic patients (25 with SMI) and 60 body composition– and age-matched control subjects. A possible correlation between these parameters and the onset of SMI was explored, and anthropometric and metabolic parameters were also analyzed.

RESULTS

Waist, levels of triglycerides, proinflammatory cytokines (interleukin-6 and tumor necrosis factor-α), HbA_1c, high-sensitivity C-reactive protein (hs-CRP), glucose, and insulin, and homeostasis model assessment of insulin resistance were higher in diabetic patients than in control subjects. However, no statistical differences in hs-CRP and insulin levels were detected when the data were adjusted for waist. None of these parameters varied between SMI and non-SMI patients. Mitochondrial function was impaired and leukocyte-endothelium interactions were more frequent among diabetic patients, which was evident in the lower mitochondrial O₂ consumption, membrane potential, polymorphonuclear cell rolling velocity, and GSH/GSSG ratio, and in the higher mitochondrial reactive oxygen species production and rolling flux, adhesion, and vascular cell adhesion molecule-1 (VCAM-1) and E-selectin molecules observed in these subjects. Moreover, these differences correlated with SMI. Statistical differences were maintained after adjusting the data for BMI and waist, with the exception of VCAM-1 levels when adjusted for waist.

CONCLUSIONS

Oxidative stress, mitochondrial dysfunction, and endothelium-inducing leukocyte-endothelium interactions are features of type 2 diabetes and correlate with SMI.Adiagnosis of diabetes worsens the prognosis of cardiovascular diseases (CVDs) to the extent that postinfarction mortality among these patients is double that of nondiabetic patients. In this sense, coronary artery disease is the major cause of morbidity and mortality in patients with diabetes, in which circumstances the prognosis is unfavorable (1), and silent myocardial ischemia (SMI) is thought to be a predictor of subclinical CVD (2).Evidence points to the involvement of impaired mitochondrial energetics in cardiac dysfunction in obesity and diabetes (3,4). Multiple abnormalities associated with diabetes, such as hyperglycemia, hyperlipidemia, and insulin resistance, are thought to contribute to adverse outcomes in diabetes after myocardial ischemia (5).The pathogenesis of mitochondrial dysfunction in obesity or diabetes-related heart disease is multifactorial and includes oxidative damage (4,6). In experimental models of obesity and diabetes, insulin resistance is commonly detected in tissues such as those in the heart (7).Oxidative stress is implicated in the etiology of the insulin resistance associated with type 2 diabetes (8). Numerous studies of nonspecific antioxidant treatments provide indirect evidence of a link between oxidative stress and insulin resistance (9). Mitochondria are the main source of reactive oxygen species (ROS), which are important markers of mitochondrial function (10). Several studies have shown that the rate of mitochondrial H₂O₂ emission is significantly greater when basal respiration is supported by fatty acids (11), raising the possibility that mitochondrial H₂O₂ emission is a primary factor in the etiology of insulin resistance.Peripheral polymorphonuclear leukocytes (PMNs) are one of the main inflammatory cell types. Once activated, PMNs release ROS, which contributes to oxidative stress and the inflammation and endothelial damage that follow. Oxidative stress occurs in the PMNs of insulin-resistant patients and is related to an impairment of mitochondrial function (8,12).The onset of many CVDs is heralded by the movement and accumulation of leukocytes in the vessel wall. These processes are mediated by an interaction between the adhesion molecules expressed on white blood and/or endothelial cells. Different cellular adhesion molecules have been implicated in atherogenesis, including vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and selectins (13).The current study was performed to throw light on the relationship between mitochondrial dysfunction, leukocyte activation, and the increase of leukocyte-endothelium interactions observed in type 2 diabetes and to explore a possible correlation between these factors and different clinical features, including SMI. We detected an increase in ROS production and PMN rolling flux, adhesion, and adhesion molecules, and a decrease in GSH levels, GSH/GSSG ratio, mitochondrial mass, membrane potential, and PMN rolling velocity, all of which are signs of an impairment of mitochondrial function and enhanced leukocyte-endothelium interaction. Our results endorse the hypothesis of an association between type 2 diabetes, mitochondrial dysfunction, and leukocyte-endothelium interaction. Additionally, they point to a correlation between these parameters and SMI, in the presence of which they were more affected.