Soluble vascular cell adhesion molecule-1 and soluble E-selectin are associated with micro- and macrovascular complications in Type 1 diabetic patients

Soedamah-Muthu, Sabita S.; Chaturvedi, Nish; Schalkwijk, Casper G.; Stehouwer, Coen D.A.; Ebeling, Pertti; Fuller, John H.; The EURODIAB Prospective Complications Study group,

doi:10.1016/j.jdiacomp.2005.06.005

« Previous Next »Journal of Diabetes and Its Complications
Volume 20, Issue 3 , Pages 188-195, May 2006

Soluble vascular cell adhesion molecule-1 and soluble E-selectin are associated with micro- and macrovascular complications in Type 1 diabetic patients

Sabita S. Soedamah-Muthu
- Department of Epidemiology and Public-Health, Royal Free and University College London Medical School, London, UK
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Corresponding author. Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Huispostnr str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands. Tel.: +31 30 250 9379; fax: +31 30 250 5485.
Nish Chaturvedi
- National Heart and Lung Institute, Imperial College London, London, UK
Casper G. Schalkwijk
- Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Internal Medicine, University Hospital Maastricht, Maastricht, the Netherlands
Coen D.A. Stehouwer
- Department of Internal Medicine and the Institute for Cardiovascular Research, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Internal Medicine, University Hospital Maastricht, Maastricht, the Netherlands
Pertti Ebeling
- Department of Medicine, Helsinki University Hospital, Helsinki, Finland
John H. Fuller
- Department of Epidemiology and Public-Health, Royal Free and University College London Medical School, London, UK
The EURODIAB Prospective Complications Study group

Received 27 August 2004; received in revised form 13 May 2005; accepted 20 June 2005.

Abstract

Objective

There are no large studies in Type 1 diabetic patients that have examined the relation between soluble adhesion molecules and micro- and macrovascular outcomes, although the risks of such complications are high. Therefore, the main objective is to examine the relationship between soluble (s) vascular cell adhesion molecule-1 (sVCAM-1) and sE-selectin and retinopathy, albuminuria, and cardiovascular disease (CVD) in Type 1 diabetic patients.

Methods

Cross-sectional data on 540 Type 1 diabetic patients, with a mean age of 40 years and diabetes duration of 22 years, from the EURODIAB Prospective Complications Study (PCS) were analysed. Retinopathy was assessed by centrally graded retinal photographs. Albumin excretion rate (AER) was used to define micro- and macroalbuminuria. CVD was defined as having physician diagnosed myocardial infarction (MI), stroke, coronary artery bypass graft (CABG) or angina, or Minnesota coded ischaemic electrocardiograms (ECGs).

Results

Unadjusted, there was a positive relationship between sVCAM-1 and sE-selectin with nonproliferative and proliferative retinopathy, micro- and macroalbuminuria, and CVD. After adjustment for age, sex, duration of diabetes, systolic blood pressure (BP), LDL-cholesterol, fasting triglycerides (TGs), smoking, body mass index (BMI), and glycated haemoglobin, as well as other complications, the strongest significant associations were shown between sVCAM-1 and macroalbuminuria, with an odds ratio of 1.83 (1.33–2.53) for every 100 ng/ml increase in sVCAM-1.

Conclusions

In this large sample of Type 1 diabetic patients, it was shown that sVCAM-1 and sE-selectin have positive associations with retinopathy, albuminuria, and CVD. This suggests that adhesion molecules are important in the pathogenesis of vascular complications in Type 1 diabetes.

Abbreviations: sVCAM-1, soluble vascular cell adhesion molecule-1, s, soluble, CVD, cardiovascular disease, BP, blood pressure, AER, albumin excretion rate, MI, myocardial infarction, CABG, coronary artery bypass graft, ECGs, electrocardiograms