2型糖尿病患者血清sVCAM-1和slCAM-1水平变化及与血管内皮功能的关系

目的　研究2型糖尿病患者可溶性血管细胞粘附分子 1(sVCAM- 1)和血浆可溶性细胞间粘附分子 1(sICAM- 1)水平的变化,并以血浆VWF水平作为内皮功能损伤的指标,观察血浆粘附分子水平与血管内皮细胞功能损伤之间的关系。方法　应用ELISA法检测62例2型糖尿病患者血浆sVCAM- 1、sICAM 1和VWF水平,并与2 0例健康人作对照。结果　糖尿病各组血清sICAM -1和sVCAM -1水平明显高于健康对照组(P <0 .0 1) ,无血管病变组、微血管病变组和大血管病变组的含量逐步升高(P <0 .0 1) :血清VWF水平在伴大血管病变组高于微血管病变组,伴微血管病变组高于无血管病变组(P <0 .0 5 ) ;无血管病变组与对照组间差异无显著性(P >0 .0 5 ) ;sICAM- 1水平与sVCAM- 1、VWF、TG、收缩压、舒张压呈正相关(P <0 .0 5 ) ;sVCAM- 1水平与LDL C、TG、TC及尿Alb/Cr呈正相关(P <0 .0 5 )。以上提示,sVCAM -1及sICAM -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型糖尿病人慢性血管并发症发生的预测及监测指标。

Study on changes of soluble vascular cell adhesion molecule-1 and soluble intercellular cell adhesion molecule-1 in type 2 diabetes mellitus

Objective To meas ure the plasma levels of soluble vascula r cell adhesion molecule-1(sVCAM-1),solu ble intercellular cell adhesion molecule -1(sICAM-1)and VWF,and to identify the r elationship between sVCAM-1 and sICAM-1 and endothelial bysfunction in type 2 di abetes mellituw.Methods plas ma levels of sVCAM-1,sICAM-1 and VWF wer e measured by ELISA in 62 type 2 diabete s mellitus and 20 healthyt controls. Results The plasma levels of sVC AM-1,sICAM-1 and VWF in type 2 diabetes mellitus were much higher than those in healthy controls(P<0.01).The plasma le vels of sVCAM-1,sICAM-1 and VWF in type 2 diabetic patients sith imcroangiopathy were higher than those in type 2 diabet ic patients without vascular complicatio n(P<0.01),but lower than those in type 2 diabetic aptients sith macroangiopath y(P<0.01).The plasma levels of VWF in type 2 diabetic patients without vascula r complicatipn were not higher than ghos e in healthy controls(P>0.05).Correlat ed analysis showed asignificant positive correlation between sICAM-1 and VWF,TG and blood pressure.And sVCAM-1 had positive correlation with LDL-c,TG,TC an d Alb/Cr(P<0.05).Conclusion Serum sVCAM-1 and sICAM-1 might partic ipate in the course of diabetic microang iopathy.The measurement of plasma sVCAM- 1and sICAM-1 levels in type 2 diabetes m ellitus may be clinically useful for ear ly discovering of endothelial dysfunctio n.