Soluble adhesion molecules and C-reactive protein in the progression of silent cerebral infarction in patients with type 2 diabetes mellitus.
The purpose of this study was to investigate the association between the progression of silent cerebral infarction (SCI) and levels of soluble adhesion molecules and high-sensitivity C-reactive protein (hs-CRP) in type 2 diabetic patients. One hundred twenty middle-aged and elderly diabetic patients without histories of vascular events were followed up for a period of 3 years. We measured levels of soluble intercellular adhesion molecule 1 (sICAM-1), vascular cell adhesion molecule 1, E-selectin, and hs-CRP and assessed brain ischemic lesions by magnetic resonance imaging at baseline and 3 years later. Silent cerebral infarction was observed in 13% of the patients at baseline, and these patients were significantly older and had significantly higher blood pressure than those without SCI. Thirty-two patients had newly diagnosed SCI after 3 years. There were no significant differences in factors such as age, blood pressure, and diabetic control between patients without SCI and those in whom it was newly diagnosed. However, only sICAM-1 levels, but not the other soluble adhesion molecules or hs-CRP, were associated with the progression of SCI, and this relationship remains after adjustment for risk factors. On the other hand, higher levels of sICAM-1 and hs-CRP at baseline were observed in 7 patients who were excluded from the present study because of the onset of symptomatic cerebral infarction during follow-up. Our present study suggests that sICAM-1 levels may be a potential marker for SCI, which may lead to future stroke and vascular dementia, and that this marker could be useful in monitoring disease progression and as a surrogate marker in treatment studies.
Kawamura
Takahiko
T
Department of Metabolism and Endocrine Internal Medicine, Chubu Rosai Hospital, Nagoya 455-8530, Japan. kawamura.hsc@chubuh.rofuku.go.jp
Umemura
Toshitaka
T
Kanai
Akio
A
Nagashima
Masahito
M
Nakamura
Nobuhisa
N
Uno
Tomoko
T
Nakayama
Mikihiro
M
Sano
Takahisa
T
Hamada
Yoji
Y
Nakamura
Jiro
J
Hotta
Nigishi
N
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D015815:Cell Adhesion Molecules / Q000097:blood* / Q000737:chemistry; D002544:Cerebral Infarction / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012995:Solubility
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein