Plasma levels of ICAM-1 and circulating endothelial cells are elevated in unstable types 1 and 2 diabetes.
OBJECTIVE
To investigate the expression and release of vascular cell-adhesion molecule (VCAM)-1, intercellular adhesion molecule (ICAM)-1, endothelial leukocyte adhesion molecule (ELAM)-1 and von Willebrand factor (vWF), as well as circulating endothelial cells (CEC) and circulating endothelial progenitor cells (CEPC), as markers of endothelial dysfunction in uncontrolled, well controlled types 1 and 2 diabetic patients and non diabetic patients.


METHODS
In this observational trans section study, soluble adhesion molecules concentrations were measured by enzyme linked immunosorbent assays and flow cytometry to detect circulating cells in 49 patients, stratified in 3 groups: G1: uncontrolled types 1 and 2 diabetic patients (n=16); G2: well controlled diabetic (types 1 and 2) patients (n=13); and G3: non diabetic patients (n=20), of whom a blood sample was obtained on admission.


RESULTS
ICAM-1 increased significantly in uncontrolled versus well controlled and non diabetic patients (721 vs. 702.45 vs. 473.46 ng/ml, p=0.016). In unstable diabetic patients, CEC were higher than in the well controlled ones (7.75 vs. 4.3/ml, p=0.386) whereas CEPC were lower in unstable diabetics (56.5 vs. 72/ml, p=0.068).


CONCLUSIONS
This study showed a continuous rise in ICAM-1 and CEC levels as stable, well controlled diabetic patients shift towards decompensation. In unstable diabetic patients, the relationship between CEC and CEPC can be represented as [CEC] alpha 1/[CEPC].
Department of Critical Care, Brugmann University Hospital, Free University of Brussels, Brussels, Belgium.
M
M
El Amine
S
S
Sohawon
L
L
Lagneau
L
L
Langneau
N
N
Gaham
S
S
Noordally
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D019040:E-Selectin / Q000097:blood; D042783:Endothelial Cells / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013234:Stem Cells / Q000473:pathology; D015854:Up-Regulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D001786:Blood Glucose; D019040:E-Selectin; D006442:Glycated Hemoglobin; D018799:Intercellular Adhesion Molecule-1; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor; C517652:hemoglobin A1c protein, human