Elevated levels of soluble E-selectin in diabetic patients with severe symptomatic peripheral arterial occlusive disease requiring angioplasty - A possible role in diabetic vascular disease?

Background. To study levels of E-selectin in patients with peripheral arter ial occlusive disease who were undergoing percutaneous transluminal angiopl asty. Methods. Experimental design and setting: Cross sectional case control stud y, conducted in a teaching hospital. Subjects: Seven patients with type-2 ( non-insulin dependent) diabetes mellitus undergoing transluminal angioplast y for symptomatic peripheral arterial occlusive disease, had blood tests fo r sE-selectin measurement, and were compared to a similar groups of age and sex matched non-diabetic patients with arteriopathy who are undergoing the same procedure. Also evaluated were a group of diabetic patients and healt hy non-diabetics with no peripheral arterial disease. Results. The levels of sE-selectin in the two diabetic, groups were signifi cantly higher than the non-diabetic groups measuring at 77 ng/ml (53-120) a nd 79 ng/ml (43-98) (median, range) vs 54 ng/ml (24-104) in the non-diabeti c with arteriopathy, and 42 ng/ml (35-66) in the normal healthy controls, p <0.04, p<0.003 respectively, Mann Whitney "U" test. Conclusions. We have demonstrated significantly high values of soluble E-se lectin in patients with diabetes mellitus requiring angioplasty for symptom atic peripheral arterial occlusive disease. This suggests that sE-selectin may be involved in the diabetic angiopathic process. It mag act as a precur sor for smooth muscle proliferation.