Improved Glycaemia in Type 1 Diabetes Results in Decreased Levels of Soluble Adhesion Molecules with No Change in Serum Adiponectin or Most Acute Phase Proteins

Abstract

Aims: To investigate how reduction of hyperglycaemia affects acute phase serum proteins in poorly controlled type 1 diabetic patients. Methods: 24 patients (age 31.7 ± 2.0 years, HbA1c 9.3 ± 0.2 %, BMI 24.2 ± 0.7 kg/m², diabetes duration 15.3 ± 1.7 years) participated in the study. The treatment was optimised for 16 weeks. Blood samples were taken at baseline and at the end of the study. 16 healthy age- and BMI-matched subjects were chosen for a control group. Results: At baseline, the patients had higher C-reactive protein (CRP) (1.09, median [range 0.24 - 18.82] mg/l vs. 0.66 [0.18 - 2.46] mg/l, p < 0.02), mean adiponectin (16.06 ± 1.31 vs. 8.85 ± 0.93 mg/l, p < 0.001), ceruloplasmin (306 ± 16.1 vs. 205.4 ± 5.5 mg/l, p < 0.001), fibrinogen (3.41 ± 0.26 vs. 2.38 ± 0.07 g/l, p < 0.001), soluble intercellular adhesion molecule-1 (sICAM-1) (255.4 ± 10.3 vs. 194 ± 10.6 µg/l, p < 0.001), soluble vascular adhesion molecule-1 (sVCAM-1) (533.4 ± 21.8 vs. 422.9 ± 20.7 µg/l, p < 0.01) and interleukin-6 (2.89 ± 0.49 vs. 1.35 ± 0.30 ng/l, p < 0.01) concentrations than the controls. During intensified treatment, HbA1c decreased (to 8.5 ± 0.2 %, p < 0.001). This resulted in reduced sE-selectin (from 44.6 ± 2.6 to 38.8 ± 2.6 µg/l, p < 0.01), α‐1-acid-glycoprotein (A1GP) (from 622.9 ± 47.9 to 525.7 ± 27.9 mg/l, p < 0.01), sICAM-1 (from 255.4 ± 10.3 to 240.8 ± 9.1 µg/l, p < 0.05) and IL-6 (from 2.9 ± 0.5 to 2.1 ± 0.4 ng/l, p < 0.01). Serum amyloid A (SAA) and CRP did not change 12.00 (0.7 - 222.0) vs. 12.00 (1.6 - 277.0) mg/l for SAA and 1.09 (0.24 - 18.82) vs. 1.09 (0.18 - 23.08) mg/l for CRP, baseline vs. treatment, respectively. Conclusions: Poorly controlled type 1 diabetic patients have increased values of adiponectin, CRP, ceruloplasmin, fibrinogen, sICAM-1, sVCAM-1 and IL-6. Reduction of hyperglycaemia results in decreased sE-selectin, A1GP, sICAM-1 and IL6, while other inflammatory factors including CRP, SAA and adiponectin are not affected.

Type 1 (insulin-dependent) diabetes mellitus - adiponectin - inflammation - soluble adhesion molecules - interleukin-6 - α1-acid glycoprotein

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