Related Experiment Videos
Circulating adhesion molecules and carotid artery structural changes in patients with noninsulin-dependent diabetes
D Rizzoni1, M L Muiesan, E Porteri
1Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy. rizzoni@master.cci.unibs.it
Insights
Essential hypertension and non-insulin-dependent diabetes mellitus (NIDDM) combined lead to more severe vascular changes than either condition alone. Adhesion molecules like ICAM-1 and VCAM-1 correlate with these structural alterations, particularly in patients with both NIDDM and hypertension.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Vascular Biology
Background:
- Hypertension and non-insulin-dependent diabetes mellitus (NIDDM) are established risk factors for atherosclerotic disease.
- Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) play roles in atherosclerosis pathogenesis and have prognostic relevance.
Purpose of the Study:
- To investigate the relationship between circulating adhesion molecule levels, carotid artery structure, and endothelial function.
- To compare these parameters in patients with NIDDM, NIDDM with essential hypertension (NIDDM+EH), essential hypertension (EH) alone, and normal subjects (NS).
Main Methods:
- Biopsy of gluteal subcutaneous fat to analyze small arteries using a micromyograph and calculate media-to-lumen (M/L) ratio.
- Doppler ultrasound to assess carotid artery structure.
- Flow-mediated dilatation (FMD) of the brachial artery to evaluate endothelial function.
- ELISA to measure plasma levels of ICAM-1 and VCAM-1.
Main Results:
- Elevated ICAM-1 and VCAM-1 levels and reduced FMD were observed in EH, NIDDM, and NIDDM+EH groups compared to NS.
- Carotid artery structural changes were most pronounced in the NIDDM+EH group.
- The M/L ratio of subcutaneous small resistance arteries was significantly higher in NIDDM+EH compared to NIDDM or EH.
- ICAM-1 plasma levels correlated with carotid artery structure indices, particularly in the NIDDM+EH group.
Conclusions:
- Combined NIDDM and essential hypertension result in more significant vascular structural alterations than either condition individually.
- Plasma levels of adhesion molecules are closely associated with carotid artery structural changes, especially in patients with comorbid NIDDM and hypertension.
- These adhesion molecule levels did not correlate with the M/L ratio of small resistance arteries.
Abstract:
Hypertension and non insulin-dependent diabetes mellitus (NIDDM) are well-known risk factors for atherosclerotic disease. Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) may exert a relevant role in the pathogenesis of atherosclerosis; their prognostic relevance has been recently demonstrated. The aim of the study was to investigate possible inter-relation between circulating adhesion molecule levels, carotid artery structure and endothelial function in 15 patients with NIDDM, as well as in 15 patients with both NIDDM and essential hypertension (NIDDM+EH) compared with 15 normal subjects (NS) and 15 euglycaemic patients with EH, matched for age, sex and body weight. All subjects were submitted to a biopsy of the gluteal subcutaneous fat. Small arteries were dissected and mounted on a micromyograph, and the media-to-lumen (M/L) ratio was then calculated. Carotid artery structure was investigated by Doppler ultrasound. Endothelial function was evaluated by investigation of the flow-mediated dilatation (FMD) of the brachial artery. ICAM-1 and VCAM-1 plasma levels were measured by ELISA. ICAM-1 and VCAM-1 plasma levels were significantly greater and FMD smaller in EH, NIDDM and NIDDM+EH than in NS, but no difference was observed among the three pathological groups. Carotid artery structural changes were more pronounced in NIDDM+EH. No significant difference was observed among NIDDM, EH and NS. The M/L ratio of subcutaneous small resistance arteries was significantly greater in NIDDM+EH than in NIDDM or EH. NS had a smaller M/L ratio than the other groups. Significant correlations were observed between ICAM-1 plasma levels and indices of carotid artery structure in diabetic patients. However, the relations were close only in NIDDM+EH. In conclusion, our data suggest that NIDDM+EH may present more pronounced vascular structural alterations than NIDDM, and that adhesion molecules plasma levels are closely inter-related with carotid artery structural alterations, at least in NIDDM+EH, but not with M/L ratio of small resistance arteries.