title: Improved glycaemia in type 1 diabetes results in decreased levels of soluble adhesion molecules with no change in serum adiponectin or most acute phase proteins.
abstract: OBJECTIVE
  To investigate how reduction of hyperglycaemia affects acute phase serum proteins in poorly controlled type 1 diabetic patients.
  
  
  METHODS
  24 patients (age 31.7 +/- 2.0 years, HbA1c 9.3 +/- 0.2%, BMI 24.2 +/- 0.7 kg/m2, diabetes duration 15.3 +/- 1.7 years) participated in the study. The treatment was optimised for 16 weeks. Blood samples were taken at baseline and at the end of the study. 16 healthy age- and BMI-matched subjects were chosen for a control group.
  
  
  RESULTS
  At baseline, the patients had higher C-reactive protein (CRP) (1.09, median [range 0.24-18.82] mg/l vs. 0.66 [0.18-2.46] mg/l, p < 0.02), mean adiponectin (16.06 +/- 1.31 vs. 8.85 +/- 0.93 mg/l, p < 0.001), ceruloplasmin (306 +/- 16.1 vs. 205.4 +/- 5.5 mg/l, p < 0.001), fibrinogen (3.41 +/- 0.26 vs. 2.38 +/- 0.07 g/l, p < 0.001), soluble intercellular adhesion molecule-1 (sICAM-1) (255.4 +/- 10.3 vs. 194 +/- 10.6 microg/l, p < 0.001), soluble vascular adhesion molecule-1 (sVCAM-1) (533.4 +/- 21.8 vs. 422.9 +/- 20.7 microg/l, p < 0.01) and interleukin-6 (2.89 +/- 0.49 vs. 1.35 +/- 0.30 ng/l, p < 0.01) concentrations than the controls. During intensified treatment, HbA1c decreased (to 8.5 +/- 0.2%, p < 0.001). This resulted in reduced sE-selectin (from 44.6 +/- 2.6 to 38.8 +/- 2.6 microg/l, p < 0.01), alpha-1-acid-glycoprotein (A1GP) (from 622.9 +/- 47.9 to 525.7 +/- 27.9 mg/l, p < 0.01), sICAM-1 (from 255.4 +/- 10.3 to 240.8 +/- 9.1 microg/l, p < 0.05) and IL-6 (from 2.9 +/- 0.5 to 2.1 +/- 0.4 ng/l, p < 0.01). Serum amyloid A (SAA) and CRP did not change 12.00 (0.7-222.0) vs. 12.00 (1.6-277.0) mg/l for SAA and 1.09 (0.24-18.82) vs. 1.09 (0.18-23.08) mg/l for CRP, baseline vs. treatment, respectively.
  
  
  CONCLUSIONS
  Poorly controlled type 1 diabetic patients have increased values of adiponectin, CRP, ceruloplasmin, fibrinogen, sICAM-1, sVCAM-1 and IL-6. Reduction of hyperglycaemia results in decreased sE-selectin, A1GP, sICAM-1 and IL6, while other inflammatory factors including CRP, SAA and adiponectin are not affected.
authors.affiliation: Division of Geriatrics, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. maikki.heliovaara@hus.fi
authors.forename: M K
authors.initials: MK
authors.lastname: Heliövaara
authors.forename: A-M
authors.initials: AM
authors.lastname: Teppo
authors.forename: S-L
authors.initials: SL
authors.lastname: Karonen
authors.forename: J A
authors.initials: JA
authors.lastname: Tuominen
authors.forename: P
authors.initials: P
authors.lastname: Ebeling
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D052242:Adiponectin / Q000097:blood; D000328:Adult; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D015536:Down-Regulation; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000628:therapy*; D008297:Male; D012107:Research Design
chemical_list: C499918:ADIPOQ protein, human; D000209:Acute-Phase Proteins; D052242:Adiponectin; D015815:Cell Adhesion Molecules