Soluble vascular cell adhesion molecule-1 and soluble E-selectin are associated with micro- and macrovascular complications in Type 1 diabetic patients.
OBJECTIVE
There are no large studies in Type 1 diabetic patients that have examined the relation between soluble adhesion molecules and micro- and macrovascular outcomes, although the risks of such complications are high. Therefore, the main objective is to examine the relationship between soluble (s) vascular cell adhesion molecule-1 (sVCAM-1) and sE-selectin and retinopathy, albuminuria, and cardiovascular disease (CVD) in Type 1 diabetic patients.


METHODS
Cross-sectional data on 540 Type 1 diabetic patients, with a mean age of 40 years and diabetes duration of 22 years, from the EURODIAB Prospective Complications Study (PCS) were analysed. Retinopathy was assessed by centrally graded retinal photographs. Albumin excretion rate (AER) was used to define micro- and macroalbuminuria. CVD was defined as having physician diagnosed myocardial infarction (MI), stroke, coronary artery bypass graft (CABG) or angina, or Minnesota coded ischaemic electrocardiograms (ECGs).


RESULTS
Unadjusted, there was a positive relationship between sVCAM-1 and sE-selectin with nonproliferative and proliferative retinopathy, micro- and macroalbuminuria, and CVD. After adjustment for age, sex, duration of diabetes, systolic blood pressure (BP), LDL-cholesterol, fasting triglycerides (TGs), smoking, body mass index (BMI), and glycated haemoglobin, as well as other complications, the strongest significant associations were shown between sVCAM-1 and macroalbuminuria, with an odds ratio of 1.83 (1.33-2.53) for every 100 ng/ml increase in sVCAM-1.


CONCLUSIONS
In this large sample of Type 1 diabetic patients, it was shown that sVCAM-1 and sE-selectin have positive associations with retinopathy, albuminuria, and CVD. This suggests that adhesion molecules are important in the pathogenesis of vascular complications in Type 1 diabetes.
Soedamah-Muthu
Sabita S
SS
Department of Epidemiology and Public-Health, Royal Free and University College London Medical School, London, UK, and Department of Internal Medicine, University Hospital Maastricht, The Netherlands. s.s.soedamah-muthu@umcutrecht.nl
Chaturvedi
Nish
N
Schalkwijk
Casper G
CG
Stehouwer
Coen D A
CD
Ebeling
Pertti
P
Fuller
John H
JH
D000328:Adult; D000419:Albuminuria / Q000652:urine; D002318:Cardiovascular Diseases / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood* / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003930:Diabetic Retinopathy / Q000097:blood / Q000652:urine; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D019040:E-Selectin; D006442:Glycated Hemoglobin; D019010:Vascular Cell Adhesion Molecule-1