Correlation between Circulating Adhesion Molecule Levels and Albuminuria in Type-2 Diabetic Hypertensive Patients

Abstract

Background/Aims: Endothelial dysfunction, a common feature among hypertensive and type-2 diabetic patients, is associated with inflammation, increased levels of circulating soluble adhesion molecules (SAM), and urinary albumin excretion. The aim of this study was to evaluate the role of circulating SAM levels in the development of albuminuria in hypertensive type-2 diabetic patients. Methods: We studied 30 hypertensive type-2 diabetic patients and 30 non-diabetic normotensive subjects, and measured their VCAM-1, ICAM-1 and E-selectin levels by ELISA, and their 24-hour urinary albumin excretion by nephelometry; the levels of circulating adhesion molecules and albuminuria were correlated with the Spearman correlation coefficient. Results: We found that the diabetic patients had significantly (p < 0.001) higher levels of circulating SAM than control subjects. When levels of circulating SAM were correlated with albuminuria, we found a significant correlation between VCAM-1 levels and 24-hour urinary albumin excretion (r = 0.4, p < 0.02). Conclusion: Our results suggest that VCAM-1 may be a marker of nephropathy in hypertensive type-2 diabetic patients.

Diabetic nephropathy and inflammation

“…Letterio et al [14] discovered that experimental models with impairment in TGF-β 1 gene are highly susceptible to several inflammation resulting in autoimmune diseases and even death [15,16] . El Mesallamy et al [8] correlated TGF-β1 concentrations with Connective tissue growth factor level; their findings showed that between these two molecules there is a closed interaction in DN.…”

“…ICAM-1 and vascular adhesion molecule-1 (VCAM-1) are involved in the attachment of leukocytes to the vascular wall and penetration into the intima, once there, leukocytes can produce proteolytic enzymes that lead to tissue and organ damage, or differentiate into foam cells that lead to the atherosclerotic process [15] . Several animal models have shown that mice deficient in ICAM-1 are resistant to nephropathy in experimental models of diabetes, while treatment with anti-ICAM-1 monoclonal Ab prevents mononuclear cell infiltration into diabetic glomeruli [3] .…”

Albuminuria Is Associated with Elevated Acute Phase Reactants and Proinflammatory Markers in HIV-Infected Patients Receiving Suppressive Combination Antiretroviral Therapy

“…VCAM-1 has been shown in numerous studies to be associated with albuminuria in the general population and in individuals with type 1 and type 2 diabetes mellitus with or without hypertension and IgA nephropathy. 26,[29][30][31][32][33][34] In addition, elevated circulating VCAM-1 has been shown to be correlated with increased VCAM-1 expression from renal biopsy in IgA nephropathy. 35 E-selectin is also found to be a strong predictor of severely increased albuminuria and coronary artery disease in patients with type 1 diabetes.…”

Advantages of ramipril/amlodipin fixed combination therapy. When should we use it?

“…Egy másik vizsgálatban az ACE-gátló és CCB fi x kombinációja csökkentette a keringő szolúbilis adhéziós molekulákat és nagyobb mértékben csökkentette a transzmembrán glükoproteinekhez tartozó, az atherosclerosis egyik fontos tényezőjének számító VCAM-1-(vascularis sejtadhéziós molekula-1) szintet, mint az ACE-gátló ön-magában [32]. Mivel e mediátorok szerepet játszanak diabetesben és hypertoniában a különböző célszervká-rosodások kialakulásában [33], ezek szintjének csökken-tése preventív hatású lehet.…”