Summary
Patients with Type 2 (non-insulin dependent) diabetes mellitus are at increased risk
of thrombosis and the premature development of atherosclerosis. This may be related
to damage to the endothelium (which may be the primary target tissue for the disease
process) resulting from a loss of normal glycaemic metabolic control. Thus changes
in endothelial cell function, such as modified release of soluble leukocyte and platelet
adhesion molecules, may be important. Accordingly, E-selec-tin, von Willebrand factor
(vWf), vascular cell adhesion molecule (VCAM) and intercellular adhesion molecule
(ICAM) were measured in serum from 60 patients and 76 controls. Raised levels of vWf
(p = 0.0002), E-selectin (p <0.0001) and VC AM (p = 0.003) in patient’s samples failed
to correlate with glycaemic control as assessed by levels of fructosamine and glycated
haemoglobin, or with 24 h urine albumin. Levels of ICAM were not increased in our
patients. Levels of the two endothelial cell products, vWf and E-selectin, failed
to correlate although E-selectin correlated with low density lipoprotein cholesterol
(p = 0.016). vWf correlated with VCAM (p <0.001) and hypertension (p = 0.032). We
conclude that levels of soluble adhesion molecules vWf, E-selectin and VCAM are raised
in Type 2 diabetes mellitus. The mechanisms for these changes appear to be independent
of glycaemic control but may relate to concurrent hypertension and/or hypercholes-terolaemia.
