Plasma concentrations of VCAM-1 and ICAM-1 are elevated in patients with Type 1 diabetes mellitus with microalbuminuria and overt nephropathy

Aims Elevated urinary albumin excretion is associated with macrovascular at herosclerotic complications in Type 1 diabetes mellitus. Adhesion molecules mediate leucocyte adhesion to the endothelium early in the atherosclerotic process. The present study tests the hypothesis that microalbuminuria and diabetic nephropathy are associated with elevated plasma concentrations of soluble vascular adhesion molecule (sVCAM)-1, soluble intercellular adhesio n molecule (sICAM)-1, and soluble E-selectin (sE-selectin) aiming to illust rate factors of potential pathogenetic relevance for the excess cardiovascu lar disease in diabetic patients with renal complications. Methods Soluble adhesion molecule concentrations were measured by enzyme-li nked immunosorbent assays (ELISA) in healthy controls (n = 16) and in 59 Ty pe 1 diabetic patients: group 1 - patients with normoalbuminuria (n = 16); group 2 - patients with microalbuminuria (n = 15); group 3 - patients with macroalbuminuria and normal serum creatinine (n = 15), group 4 - patients w ith macroalbuminuria and moderately elevated serum creatinine (n = 13). Results Plasma concentrations of sVCAM-1 and sICAM-1 were similar in health y controls and normoalbuminuric Type 1 diabetic patients, but the concentra tions were increased by the presence of microalbuminuria and overt nephropa thy (P < 0.001 and P < 0.0001, ANOVA). Concentrations of sE-selectin did no t differ between diabetic patients and controls. Conclusions Plasma concentration of sICAM-1 is elevated in Type 1 diabetic patients with microalbuminuria and the concentrations of sICAM-1 as well as sVCAM-1 are elevated in patients with macroalbuminuria and normal s-creati nine. The elevated plasma concentrations of these soluble adhesion molecule concentrations in patients with renal complication can be of pathogenetic importance for the development of atherosclerosis and plasma soluble adhesi on molecule concentrations may provide additional information on cardiovasc ular risk.