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Soluble CD40 ligand, soluble P-selectin, interleukin-6, and tissue factor in diabetes mellitus: relationships to
Hoong Sern Lim1, Andrew D Blann, Gregory Y H Lip
1Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Dudley Road, Birmingham, B18 7QH, England, UK.
Circulation
|May 12, 2004
Summary
Intensive cardiovascular risk management lowered soluble CD40 ligand (sCD40L) in diabetes patients. However, benefits for platelet activation and coagulation were limited, especially for those with established cardiovascular disease (CVD).
Area of Science:
- Cardiovascular Medicine
- Diabetes Research
- Inflammation and Thrombosis
Background:
- Elevated soluble CD40 ligand (sCD40L) is linked to cardiovascular disease (CVD).
- CD40L-CD40 interactions contribute to atherothrombosis.
- Diabetes mellitus is a major risk factor for CVD.
Purpose of the Study:
- To assess if intensive multifactorial cardiovascular risk intervention reduces markers of platelet activation, inflammation, and coagulation in diabetes patients.
- To compare intervention benefits in diabetic patients with and without overt CVD.
Main Methods:
- Measured plasma levels of sCD40L, soluble P-selectin (sP-sel), interleukin-6 (IL-6), and tissue factor (TF) in diabetic patients and controls.
- Assessed the impact of a 1-year multifactorial intervention package on these markers in diabetic patients.
Main Results:
- Diabetic patients had higher sCD40L, sP-sel, IL-6, and TF compared to controls; TF was highest in those with overt CVD.
- Intervention significantly reduced sCD40L in all diabetic patients.
- Reductions in sP-sel and TF were observed only in diabetic patients without overt CVD.
- IL-6 levels did not change significantly in either patient group.
Conclusions:
- Intensive multifactorial risk management effectively lowers sCD40L in diabetes.
- The intervention partially corrects abnormal platelet activation and coagulation in diabetes.
- Patients with overt CVD experienced less benefit from the intervention regarding these markers.
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