Evaluation of biochemical and clinical markers of endothelial dysfunction and their correlation with urinary albumin excretion in patients with type 1 diabetes mellitus

Polat, Sefika Burcak; Ugurlu, Nagihan; Aslan, Nabi; Cuhaci, Neslihan; Ersoy, Reyhan; Cakir, Bekir

doi:10.1590/2359-3997000000116

Acessibilidade / Reportar erro

Brasil

Archives of Endocrinology and Metabolism

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Arch. Endocrinol. Metab. 60 (2) • Apr 2016 • https://doi.org/10.1590/2359-3997000000116 copy

Evaluation of biochemical and clinical markers of endothelial dysfunction and their correlation with urinary albumin excretion in patients with type 1 diabetes mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

Endothelial dysfunction (ED) plays an important role in the pathogenesis of diabetic nephropathy. The purpose of the study was to determine flow mediated endothelial dependent vasodilatation (FMD) measurements and serum soluble (s) endothelin-1 (ET-1), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule (VCAM-1) levels in patients with type 1 diabetes mellitus (T1DM) with or without increased urinary albumin excretion (UAE) and compare them with the healthy controls.

Subjects and methods

Seventy three patients with T1DM were enrolled. Patients were divided into two subgroups according to microalbumin measurements in 24-hr urine collections. The diabetic patients without microalbuminuria (41 patients) were defined as Group I and those with microalbuminuria (32 patients) were defined as group II. A hundred age and sex matched healthy subjects participated as the control group (Group III). Serum sET-1, sICAM-1, sVCAM-1 levels and FMD measurements were determined in all participants.

Results

Median FMD measurement was significantly lower in the diabetic groups compared with the control group (6.6, 6.4 and 7.8% in Group I, II and III, respectively) (p < 0.05). FMD was negatively correlated with age (p = 0.042). Median serum sICAM-1 level was higher in the patient groups compared to the control group (p < 0.05). Median serum sVCAM-1 level was higher in the group of patients with increased albuminuria compared to the normoalbuinuric and the control group (p < 0.05). Serum sVCAM-1 level was found to be positively correlated with degree of urinary albumin excretion (p < 0.001).

Conclusion

We assume that sVCAM-1 may be used as a predictive marker for risk stratification for nephropathy development and progression.

Nephropathy; ET-1; VCAM-1; ICAM-1; FMD; endothelial dysfunction

Variables	Group I (n = 41)	Group II (n = 32)	Group III (n = 100)	p-value
Age (years)	33.3 ± 9.0	33.7 ± 10.7	35.7 ± 7.7	0.060^†
Female/male	20/21	16/16	50/50	0.992^‡
DM duration	8 (5-15)	11.5 (5-25)	-	0.059^¶
HT	4 (9.8%)	7 (22.6%)	1 (4.0%)	0.087^#
LDL mg/dL	99.0 ± 39.2	115.2 ± 37.7	113.3 ± 3.6	0.139^†
HDL mg/dL	47 (31-68)^a	50 (27-110)	56 (29-88)^a	0.016 ^$
TG mg/dL	93 (45-220)	100 (47-333)	109 (46-513)	0.440^$
Creatine mg/dL	0.89 (0.50-1.60)	0.80 (0.60-2.10)	0.70 (0.4-1.2)	0.680^$
HbA1c %	8.9 (5.6-12.0)^a	9.2 (6.0-12.3)^b	5.3 (4.4-6.3)^a,b	< 0.001 ^$

Groups	sET-1 Median (minimum maximum) (fmol/l)	sICAM-1 Median (minimum-maximum) (ng/mL)	sVCAM-1 Median (minimum maximum) (ng/mL)
Group I (n = 41)	8.1 (0.6-16.5)	5100 (1450-12860)^a	736.5 (419.9-1516.7)^c
Group II (n = 32)	7.7 (3.1-23.5)	4520 (326.1-11070)^b	975.9 (352.2-1525.5)^b,c
Group III (n = 100)	10.5 (3.0-19.0)	685.7 (120-14460)^a,b	680.1 (380.0-1041.9)^b
p-value^†	0.066	< 0.001	0.002

Groups	FMD (%)
Group I (n = 41)	6.6 (3.1-10.3)^a
Group II (n = 32)	6.4 (4.3-11.1)^b
Group III (n = 100)	7.8 (3.1-12.0)^a,b
p-value^†	0.013

Variables	ICAM-1		VCAM-1		ET-1		FMD
	r-value	p-value	r-value	p-value	r-value	p-value	r-value	p-value^†
Age	0.038	0.755	0.044	0.724	-0.063	0.608	-0.247	0.042
DM duration	-0.151	0.202	0.100	0.401	0.110	0.352	0.002	0.985
HbA1c	-0.043	0.725	-0.001	0.994	0.144	0.242	0.209	0.087
UAE	-0.085	0.472	0.443	< 0.001	-0.084	0.480	-0.016	0.891

Sociedade Brasileira de Endocrinologia e Metabologia Rua Botucatu, 572 - Conjuntos 81/83, 04023-061 São Paulo SP Brasil, Tel: (55 11) 5575-0311 - São Paulo - SP - Brazil
E-mail: aem.editorial.office@endocrino.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence to: Sefika Burcak Polat. Yildirim Beyazit University, Ataturk Education and Research Hospital, Department of Endocrinology and Metabolism, 06800 – Bilkent, Ankara. burcakugurlu@gmail.com