INCREASED LEVELS OF SOLUBLE ADHESION MOLECULES IN TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS ARE INDEPENDENT OF GLYCEMIC CONTROL

Patients with Type 2 (non-insulin dependent) diabetes mellitus are at increased risk of thrombosis and the premature development of atherosc lerosis. This may be related to damage to the endothelium (which may b e the primary target tissue for the disease process) resulting from a loss of normal glycaemic metabolic control. Thus changes in endothelia l cell function, such as modified release of soluble leukocyte and pla telet adhesion molecules, may be important, Accordingly, E-selectin, v on Willebrand factor (vWf), vascular cell adhesion molecule (VCAM) and intercellular adhesion molecule (ICAM) were measured in serum from 60 patients and 76 controls. Raised levels of vWf (p = 0.0002), E-select in (p < 0.0001) and VCAM (p = 0.003) in patient's samples failed to co rrelate with glycaemic control as assessed by levels of fructosamine a nd glycated haemoglobin, or with 24 h urine albumin. Levels of ICAM we re not increased in our patients. Levels of the two endothelial cell p roducts, vWf and E-selectin, failed to correlate although E-selectin c orrelated with low density lipoprotein cholesterol (p = 0.016). vWf co rrelated with VCAM (p < 0.001) and hypertension (p = 0.032). We conclu de that levels of soluble adhesion molecules vWf, E-selectin and VCAM are raised in Type 2 diabetes mellitus. The mechanisms for these chang es appear to be independent of glycaemic control but may relate to con current hypertension and/or hypercholesterolaemia.