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Biomarcadores de la disfunción endotelial y el riesgo de diabetes mellitus tipo 2
James B Meigs1, Frank B Hu, Nader Rifai
1General Medicine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Mass 02114, USA. jmeigs@partners.org
JAMA
|April 29, 2004
Resumen
Los niveles elevados de E-selectina e ICAM-1 predicen la diabetes tipo 2 en las mujeres. Estos biomarcadores de la disfunción endotelial indican riesgo incluso sin obesidad o inflamación.
Área de la Ciencia:
- Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular Investigación Cardiovascular
- Endocrinología Endocrinología.
- Epidemiología La epidemiología.
Sus antecedentes:
- La disfunción endotelial está relacionada con la diabetes mellitus tipo 2.
- Puede preceder al diagnóstico clínico de diabetes.
Objetivo del estudio:
- Investigar si los biomarcadores plasmáticos de la disfunción endotelial predicen el desarrollo de diabetes tipo 2 en mujeres no diabéticas inicialmente.
- E-selectina evaluada, molécula de adhesión intercelular 1 (ICAM-1) y molécula de adhesión celular vascular 1 (VCAM-1).
Principales métodos:
- Estudio prospectivo y anidado de casos y controles dentro del Estudio de Salud de las Enfermeras.
- Incluido 32.826 mujeres que proporcionan muestras de sangre; 737 desarrollaron diabetes incidente para el año 2000.
- Análisis del riesgo basado en los niveles de biomarcadores basales, ajustando por múltiples covariables.
Principales resultados:
- Niveles medios significativamente más altos de E-selectina, ICAM-1 y VCAM-1 en mujeres que desarrollaron diabetes.
- Los niveles elevados de E-selectina y ICAM-1 predijeron la incidencia de diabetes tipo 2.
- Los riesgos relativos ajustados fueron de 5,43 para la E-selectina y de 3,56 para la ICAM-1 en el quintil superior.
Conclusiones:
- Los biomarcadores de la disfunción endotelial predicen la diabetes tipo 2 en las mujeres.
- Esta predicción es independiente de la obesidad y la inflamación subclínica.
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