2型糖尿病患者血清可溶性细胞间粘附分子1水平变化及与血管内皮功能的关系

目的研究2型糖尿病患者血清可溶性细胞间粘附分子1水平的变化,并以血浆假性血友病因子水平作为内皮功能损伤的指标,观察细胞间粘附分子1与血管内皮细胞功能损伤之间的关系。方法62例2型糖尿病患者按照有无血管并发症分为无血管病变组(n=19)、微血管病变组(n=20)和大血管病变组(n=23),选择20例健康者作为对照组。应用酶联免疫吸附法检测各组患者血清可溶性细胞间粘附分子1水平和血浆假性血友病因子水平,并测定糖脂代谢指标和尿微量白蛋白水平。结果2型糖尿病患者血清可溶性细胞间粘附分子1水平明显高于健康对照组(P<0.01),在无血管病变组、微血管病变组和大血管病变组的水平逐步升高(P<0.01);血浆假性血友病因子水平在大血管病变组高于微血管病变组,微血管病变组高于无血管病变组(P<0.01),无血管病变组与对照组间无显著性差异。可溶性细胞间粘附分子1与血浆假性血友病因子、甘油三酯、收缩压、舒张压呈正相关(r分别为0.43、0.45、0.52和0.62,P<0.01)。结论细胞间粘附分子1可能参与了2型糖尿病血管病变的发生和发展,可作为早期2型糖尿病患者慢性血管并发症尤其是大血管病变发生的预测及监测指标。

Changes of Serum Soluble Intercellular Adhesion Molecule-1 and Its Relations with Endothelial Dysfunction in Type 2 Diabetes Mellitus Patients

Aim To study the Changes of serum soluble intercellular adhesion molecule-1(sICAM-1) and its relations with endothelial dysfunction in type 2 diabetes mellitus patients. Methods 62 cases of type 2 diabetes were divided into three groups: complication free group(n=19),microangiopathy group(n=20) and macroangiopathy group(n=23).20 normal subjects were served as normal control group(n=20).Levels of sICAM-1 and von Willebrand factor(vWF) were measured by enzyme linked immunosorbent assay(ELISA). Results The levels of sICAM-1 and vWF in type 2 diabetes mellitus were higher than those in healthy controls(P<(0.01)).The levels of sICAM-1 and vWF in type 2 diabetic patients with microangiopathy were higher than those without vascular complication(P<(0.01)),but lower than those with macroangiopathy(P<(0.01)).The levels of vWF in type 2 diabetic patients without vascular complication were not higher than those in healthy controls (P>0.05).There was a significant positive correlation between sICAM-1 and vWF,triglyceride and diastolic blood pressure(r=0.43,r=0.45, r=0.52 and r=0.62,P<0.01). Conclusions Serum sICAM-1 might participate in the course of diabetic microangiopathy.The measurement of serum sICAM-1 levels in type 2 diabetes mellitus may be clinically useful for early discovering of endothelial dysfunction.