ENDOTHELIAL ACTIVATION IN YOUNG ADULTS WITH TYPE 1A DIABETES MELLITUS: AN EVALUATION OF SOLUBLE CELLULAR ADHESION MOLECULES
Endothelial Activation in Young Adults with Type 1A Diabetes Mellitus: An Evaluation of Soluble Cellular Adhesion Molecules - INTRODUCTION-Individuals with Type 1A diabetes mellitus (DM) have an elevated risk for the premature development of severe, atherosclerotic disease. Leukocyte adhesion to the vascular endothelium is an important process in the development of atherosclerosis. These interactions are mediated in part by cellular adhesion molecules (CAMs). Soluble CAMs in the circulation reflect the degree of endothelial activation. It is thought that endothelial activation may play a role in diabetic vascular disease. OBJECTIVES-The purpose of this cross-sectional study is to examine a wide panel of soluble CAMs in young adults with Type 1A DM and compare them to healthy young adult controls. Additionally we will examine the relationships between soluble CAMs and two clinical measurements that are thought to predict the future development of cardiovascular disease, 24-hour ambulatory blood pressure (ABP) and albumin excretion rate (AER).METHODS-A panel of soluble CAMS were measured using ELISA in 78 normoalbuminuric, non-hypertensive, young adults with Type 1A DM and compared to 94 controls. Overnight albumin excretion rate was measured for all diabetic subjects. In a subset of the cohort, 60 Type 1A diabetics and 74 healthy controls successfully completed 24-hour ambulatory blood pressure monitoring.RESULTS-We found that P-selectin, E-selectin, VCAM-1 and ICAM-1 were all significantly (p<0.01) elevated in the young adults with Type 1A DM. In a multiple regression model, glycosylated hemoglobin (HgA1c) was a significant independent predictor of ICAM-1 levels. P-selectin and HgA1c were both significant independent predictors of ambulatory systolic day and night blood pressure, while PECAM-1 was a negative independent predictor of systolic day-night blood pressure difference. Using logistic regression, PECAM-1 was found to be a negative independent predictor of albumin excretion. CONCLUSIONS-In young adult diabetics endothelial activation is elevated and is related to early adverse changes in ambulatory blood pressure. Our findings suggest that that endothelial activation may be occurring even in apparently healthy young adults with Type 1A DM, which may put them at increased risk for the future development of cardiovascular disease.
School:University of Cincinnati
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:diabetes mellitus adhesion molecules cardiovascular disease
Date of Publication:01/01/2002