Tetranectin, soluble P-selectin and VCAM-1 in the plasma of children with insulin-dependent diabetes mellitus

Objectives: Insulin-dependent diabetes mellitus (IDDM) is an autoimmune dis order characterized by a variety of haemostatic abnormalities. The purpose of this study was to investigate the levels of tetranectin (TN), a regulato r of fibrinolysis, in the plasma of IDDM children in relation to HbA1c leve ls and to the state of platelet and endothelial cells activation expressed by the levels of circulating P-selection (cP-selectin) and VCAM-1 (cVCAM-1) . Patients and methods: TN, cP-selectin and cVCAM-1 levels were assessed by E LISA in the plasma of 75 uncomplicated IDDM children and compared with thos e of 33 healthy subjects. Patients were divided into subgroups A and B acco rding to the levels of HbA1c (HbA1c less than or equal to 6.8% and HbA1c > 6.8% respectively). Results: TN levels have the tendency to be higher in IDDM children [14.98(1 2.50-18.10) mg/L, P = 0.0210] compared to those in healthy subjects [13.44( 10.48-16.32) mg/L] and were significantly higher in subgroup B than in subg roup A [16.92(13.48-18.26) mg/L vs 13.68(11.35-14.89) mg/L respectively, P = 0.0120]. The plasma levels of cP-selectin and cVCAM-1 were significantly elevated in IDDM [301(218-401) ng/ml, P = 0.0004 and 997(814-1222) ng/ml, P = 0.0015 respectively] than in healthy subjects [201(135-243) ng/ml, and 7 24(602-864) ng/ml respectively]. A trend towards higher cP-selectin levels was observed in subgroup B compared to subgroup A. As regards cVCAM-1, no s tatistically significant difference was found between subgroups A and B. A significant correlation was found between cP-selectin and cVCAM-1 (r(s) = 0 .32, P = 0.034), while no correlation was found between these variables and TN or HbA1c. However, a significant correlation was observed between TN an d HbA1c (r(s), = 0.37, P = 0.011) in all IDDM patients. Likewise, a longitu dinal follow up of 10 IDDM patients revealed a positive correlation between TN and HbA1c in each patient. Conclusions: These data provide evidence for VN elevation with the increase of HbA1c in uncomplicated IDDM children, suggestive of TN involvement in t he haemostatic abnormalities in IDDM. The mechanism by which this would occ ur is discussed.