Abstract
doiBackground and aims: It is known that endothelial dysfunction and low-grade inflammation are important element of diabetic complications. The soluble E-selectin is a marker of endothelial dysfunction and C-reactive protein is the most important inflammatory marker. The present study is done to investigate the effect of diabetes on these two markers. Methods: The present hospital based case control study was conducted in the department of Biochemistry with the collaboration of department of Medicine of Burdwan Medical College, Burdwan, west Bengal India. All subjects were selected by simple random sampling between March 2011 and May 2013. Blood level of these soluble E-selectin and high sensitive C-reactive protein were measured in two hundred diabetic and two hundred age, sex and other non-modifiable as well as modifiable risk factors matched non-diabetic healthy controls. Results: Compared with control value of high sensitive C-reactive protein and soluble E-selectin levels were higher in diabetic subjects (p < 0.001). Our present study shows that levels of adhesion molecules and high sensitive C-reactive protein were higher in diabetic than non-diabetic. Conclusion: These data suggested that an increased level of inflammatory markers and adhesion molecules among diabetic compared with non-diabetic subjects. This suggests that chronic uncontrolled hyperglycemia contributes to progression of atherosclerosis associated with life-threading complications in middle-aged diabetic patients. DOI: http://dx.doi.org/10.3126/jaim.v3i1.10697 Journal of Advances in Internal Medicine 2014;03(01):17-22
Highlights
[2] The reduced uptake of glucose into muscle and adipose tissue leads to chronic extra cellular hyperglycemia that results in tissue damage and micro as well as macrovascular complications in both type I and II Diabetes Mellitus. [3,4] The development of endothelial dysfunction is considered an important element of diabetic microvascular disease
[15] Among several markers of inflammation CRP is a pentameric protein produced by the liver, has emerged as the “golden marker of inflammation”. [2,16] So, current study focuses on association of hsCRP as an inflammatory marker and sE-selectin as a marker of inflammation with hyperglycemia to detect prognostic implication in both micro and macro-vascular complication of uncontrolled diabetes mellitus
It has long been proposed that damage to the endothelium is important in the development and/or progression of atherosclerosis, [35] and increased levels of endothelial cell markers in the plasma of subjects who go onto suffer adverse cardiovascular events support this concept. [36,37] Among the most commonly used endothelial cell markers are von Willebrand factor, soluble thrombomodulin, and soluble E-selectin. [11,12,13] In present study it was found that an important marker of endothelial dysfunction sE-selectin, was found at significantly higher levels in diabetic patients than in non-diabetic subjects
Summary
Diabetes is characterized by hyperglycemia and metabolic abnormalities due to decreased insulin level or action, causing metabolic and physiological changes in various organs. [1] It is associated with disturbances concerned with protein, carbohydrate and lipid metabolism. [2] The reduced uptake of glucose into muscle and adipose tissue leads to chronic extra cellular hyperglycemia that results in tissue damage and micro as well as macrovascular complications in both type I and II Diabetes Mellitus. [3,4] The development of endothelial dysfunction is considered an important element of diabetic microvascular disease. [5] The adherence of circulating leucocytes to dysfunctional endothelium and their subsequent transmigration into the arterial intima is the subsequent step of the complication. [2,16] So, current study focuses on association of hsCRP as an inflammatory marker and sE-selectin as a marker of inflammation with hyperglycemia to detect prognostic implication in both micro and macro-vascular complication of uncontrolled diabetes mellitus. The mechanisms underlying this finding remain unexplained, but connection with abnormal endothelial function and chronic low grade inflammation in patients with type 2 DM remain unknown. The present study was to investigate the relation with abnormal endothelial function and chronic low grade inflammation in patients with type 2 DM. The present study is done to investigate the effect of diabetes on these two markers
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