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Elevated Concentrations of Soluble E-Selectin and Vascular Cell Adhesion Molecule-1 in NIDDM: Effect of intensive insulin treatment

  1. Jean-Paul Albertini, MD, PHD,
  2. Paul Valensi, MD,
  3. Boris Lormeau, MD,
  4. Marie-Hélène Aurousseau, MD,
  5. Francoise Ferrière,
  6. Jean-Raymond Attali, MD and
  7. Liliane Gattegno, MD, PHD
  1. Laboratory of Biochemistry and Cell Biology, Hôpital Avicenne Bobigny
  2. Department of Endocrinology, Diabetology, and Nutrition, Hôpital Jean Verdier Bondy, France
  3. Laboratory of Hematology, Hôpital Jean Verdier Bondy, France
  4. Laboratory of Biochemistry, Hôpital Jean Verdier Bondy, France
  1. Address correspondence and reprint requests to Dr. J.-R Albertini, Laboratoire de Biochimie, Hopital Avicenne, 125 rue de Stalingrad, 93009 Bobigny Cedex, France. E-mail: jean-paul.albertini{at}avc.ap-hop-paris.fr

Abstract

OBJECTIVE To evaluate the effects of a 14-day intensive insulin therapy and short-term improvement of glycemic control on serum levels of soluble forms of adhesion molecules, i.e., intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin (sE-selectin) in NIDDM patients with poor glycemic control.

RESEARCH DESIGN AND METHODS A total of 16 NIDDM patients were compared with 23 healthy subjects (control group) and investigated before and after intensive insulin treatment.

RESULTS On day 0, sE-selectin and sVCAM-1 levels were significantly higher in NIDDM patients than in nondiabetic control subjects (median 87, range 63–115; median 544, range 408–797 vs. 58, 43–80; 443, 395–573 ng/ml, respectively) (P < 0.008 in both cases). On day 15, the fall in sE-selectin levels was significant (P < 0.0001) and at a lesser extent in sVCAM-1 levels (64, 48–85; 506, 417–678 ng/ml, respectively); these levels reached values that no longer differed from those of control subjects (P = 0.23 and 0.15, respectively). Moreover, the fall in sE-selectin was positively associated with the change in LDL cholesterol and the improvement of glycemia.

CONCLUSIONS In poorly controlled NIDDM patients, sE-selectin levels are increased and significantly fall to normal after short-term improvement of glycemic control. This suggests that assaying sE-selectin makes it possible to detect endothelium activation and to follow its reversal with euglycemia.

  • Received August 5, 1997.
  • Accepted February 26, 1998.
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