title: Relationship between hemoglobin and CD40 ligand in prediabetes.
abstract: OBJECTIVE
  Hemoglobin (Hb) regulates the endothelial function by modulating the bio-availability of NO at the tissue level. A significant direct relationship is present between the Hb levels and endothelial functions in patients with Type 2 diabetes. Testing whether this association also exists in subjects with prediabetes is important because prediabetes is associated with an increased risk of cardiovascular disease and mortality. Therefore, we investigated the association of Hb both with the classical cardiac risk factors and the markers for endothelial dysfunction and inflammation, in subjects with impaired glucose tolerance (IGT).
  
  
  METHODS
  We enrolled 69 normotensive, and cardiovascular events free subjects with IGT (M=40, age=45.50+/-6.8 yr). Plasma insulin, hsCRP, soluble CD40L, vonWillebrand factor, p-selectin levels were measured. The parameters given according to the higher and lower median Hb values of the subjects were compared.
  
  
  RESULTS
  Subjects with the higher Hb levels exhibited lower HDL-C (46.68+/-10.8 mg/dl vs 51.5+/-8.9 mg/dl; P=0.04) and higher systolic (122.57+/-6.2 mmHg vs 116.17+/-7.4 mmHg; p < 0.001) and diastolic (79.14+/-3.73 mmHg vs 75.58+/-6.1 mmHg; P=0.005) blood pressures and sCD40L (7.9+/-3.8 ng/ml vs 6.07+/-2.1 ng/ml; P=0.02) levels. Hb levels were correlated to the HDL cholesterol, sCD40L, systolic and diastolic blood pressures and waist circumference (r=-0.28, P=0.02; r=0.29, P=0.02; r=0.53, P < 0.001; r=0.41, P=0.001; r=0.42, P < 0.001 respectively). According to the multiple logistic regression analysis, Hb was the determinant of sCD40L levels (beta=0.437, P < 0.001).
  
  
  CONCLUSIONS
  These results indicate that there may be a link with higher Hb values and cardiovascular risk factors in patients with IGT. Further investigation is warranted to understand the clinical implications of these findings in subjects with prediabetes.
authors.affiliation: Department of Endocrinology, Gulhane Medical School, Etlik, 06018 Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kutlu
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
authors.forename: Halil
authors.initials: H
authors.lastname: Genc
authors.forename: Gokhan
authors.initials: G
authors.lastname: Erdem
authors.forename: Serkan
authors.initials: S
authors.lastname: Tapan
authors.forename: Gurkan
authors.initials: G
authors.lastname: Celebi
authors.forename: Cem
authors.initials: C
authors.lastname: Haymana
authors.forename: Abdullah
authors.initials: A
authors.lastname: Taslipinar
authors.forename: Gokhan
authors.initials: G
authors.lastname: Uckaya
authors.forename: Mehmet Kemal
authors.initials: MK
authors.lastname: Erbil
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D023201:CD40 Ligand / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000097:blood* / Q000503:physiopathology
chemical_list: D006454:Hemoglobins; D007328:Insulin; D023201:CD40 Ligand; D002097:C-Reactive Protein