Elevated concentrations of soluble E-selectin and vascular cell adhesion molecule-1 in NIDDM. Effect of intensive insulin treatment.
OBJECTIVE
To evaluate the effects of a 14-day intensive insulin therapy and short-term improvement of glycemic control on serum levels of soluble forms of adhesion molecules, i.e., intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin (sE-selectin) in NIDDM patients with poor glycemic control.


METHODS
A total of 16 NIDDM patients were compared with 23 healthy subjects (control group) and investigated before and after intensive insulin treatment.


RESULTS
On day 0, sE-selectin and sVCAM-1 levels were significantly higher in NIDDM patients than in nondiabetic control subjects (median 87, range 63-115; median 544, range 408-797 vs. 58, 43-80; 443, 395-573 ng/ml, respectively) (P < 0.008 in both cases). On day 15, the fall in sE-selectin levels was significant (P < 0.0001) and at a lesser extent in sVCAM-1 levels (64, 48-85; 506, 417-678 ng/ml, respectively); these levels reached values that no longer differed from those of control subjects (P = 0.23 and 0.15, respectively). Moreover, the fall in sE-selectin was positively associated with the change in LDL cholesterol and the improvement of glycemia.


CONCLUSIONS
In poorly controlled NIDDM patients, sE-selectin levels are increased and significantly fall to normal after short-term improvement of glycemic control. This suggests that assaying sE-selectin makes it possible to detect endothelium activation and to follow its reversal with euglycemia.
Albertini
J P
JP
Laboratory of Biochemistry and Cell Biology, Hôpital Avicenne, Bobigny, France. jean-paul.albertini@avc.ap-hop-paris.fr
Valensi
P
P
Lormeau
B
B
Aurousseau
M H
MH
Ferrière
F
F
Attali
J R
JR
Gattegno
L
L
D001053:Apolipoproteins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003327:Coronary Disease / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000276:immunology; D003925:Diabetic Angiopathies / Q000097:blood; D003928:Diabetic Nephropathies / Q000097:blood; D003929:Diabetic Neuropathies / Q000097:blood; D003930:Diabetic Retinopathy / Q000097:blood; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D001053:Apolipoproteins; D015415:Biomarkers; D001786:Blood Glucose; D019040:E-Selectin; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; D008074:Lipoproteins; D019010:Vascular Cell Adhesion Molecule-1