Association between future events of brain infarction and soluble levels of intercellular adhesion molecule-1 and C-reactive protein in patients with type 2 diabetes mellitus.
We investigated the influence of the reciprocal association between serum levels of high-sensitivity C-reactive protein (hs-CRP) and intercellular adhesion molecule-1 (sICAM-1) on the risk of brain infarction in type 2 diabetic patients. One hundred seventy nine middle-aged and elderly diabetic patients without histories of cardiovascular events were followed up for an average of 8 years. Fourteen patients developed symptomatic brain infarction (BI) during follow-up. These patients had significantly higher blood pressure, longer duration of diabetes, silent brain infarction, microvascular complications such as macroalbuminuria, and higher creatinine, sICAM-1 and hs-CRP levels at baseline as compared with those without BI. A high risk of stroke was observed in patients with high levels of sICAM-1 (>260microg/L) and hs-CRP (>0.83mg/L) at baseline, respectively, and patients with high levels of both were more likely to develop BI. In addition, sICAM-1 levels were significantly correlated with systolic blood pressure and glycemic control index, whereas hs-CRP levels were correlated with fasting insulin levels, HDL-cholesterol, triglycerides, and uric acid. Consequently, sICAM-1 and hs-CRP levels were, respectively, reflected in different cardiovascular risk factors. This study suggests that both measurements of hs-CRP and sICAM-1 levels are useful as a predictor of future stroke in diabetic subjects.
Kanai
Akio
A
Department of Metabolism and Endocrine Internal Medicine, Chubu Rosai Hospital, Nagoya, Japan.
Kawamura
Takahiko
T
Umemura
Tositaka
T
Nagashima
Masahito
M
Nakamura
Nobuhisa
N
Nakayama
Mikihiro
M
Sano
Takahisa
T
Nakashima
Eitaro
E
Hamada
Yoji
Y
Nakamura
Jiro
J
Hotta
Nigishi
N
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D020520:Brain Infarction / Q000209:etiology / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000378:metabolism; D014527:Uric Acid / Q000378:metabolism
D001786:Blood Glucose; D014280:Triglycerides; D018799:Intercellular Adhesion Molecule-1; D014527:Uric Acid; D002097:C-Reactive Protein