Soluble L-selectin level is a marker for coronary artery disease in type 2 diabetic patients.
OBJECTIVE
To investigate whether the fall in soluble L-selectin (sL-selectin) level constitutes a marker for myocardial ischemia.


METHODS
The levels of soluble forms of adhesion molecules, i.e., intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin), P-selectin (sP-selectin), and L-selectin (sL-selectin), were compared in type 2 diabetic patients without inflammatory syndrome but with symptomatic coronary artery disease (CAD) (group 1, n = 11), with silent ischemic disorders and proven coronary stenoses (group 2, n = 11), with silent myocardial ischemia (SMI) and normal coronary angiography (group 3, n = 10), and without proven SMI (group 4, n = 13). These levels were compared with those of 22 control subjects.


RESULTS
The sL-selectin level was significantly lower in groups 1, 2, or 3 with symptomatic CAD or with SMI as compared with the control group (P = 0.0004). Group 4 without myocardial ischemia did not significantly differ from the control subjects (P = 0.6). In type 2 diabetic patients, after controlling for HbA1c, a partial correlation between sL-selectin and the CAD status was significant (P = 0.001). sICAM-1 and sP- or sE-selectin did not differ significantly between type 2 diabetic patients and control subjects or among the different groups of patients. The sVCAM-1 level in type 2 diabetic patients was significantly higher than in the control subjects (P = 0.001), but there were no significant intergroup differences (P = 0.4).


CONCLUSIONS
In type 2 diabetic patients, sVCAM-1 is increased with regard to glycemic control, whatever the CAD status. In type 2 diabetic patients with symptomatic CAD or SMI associated with coronary stenoses, sL-selectin is significantly decreased. A marked fall in sL-selectin might constitute a marker for silent CAD in type 2 diabetic patients.
Albertini
J P
JP
Laboratory of Biochemistry, CHU Avicenne, Bobigny, France. jean-paul.albertini@avc.ap-hop-paris.fr
Valensi
P
P
Lormeau
B
B
Vaysse
J
J
Attali
J R
JR
Gattegno
L
L
D000368:Aged; D015415:Biomarkers; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin; D006801:Humans; D019041:L-Selectin / Q000097:blood*; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis; D012995:Solubility; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D008078:Cholesterol, LDL; D019270:Fructosamine; D006442:Glycated Hemoglobin; D019041:L-Selectin; D014280:Triglycerides