[Selected adhesion molecules: sICAM-1 and sVCAM-1 as markers of endothelial dysfunction in diabetic children and adolescence]

Abstract

Atherosclerotic process is accelerated in children with atherosclerosis risk factors, such as type 1 diabetes. Infiltration of the vessel wall by monocytes and lymphocytes, which starts atherosclerotic process, takes place under influence of adhesion molecules. Adhesion molecules play an important role in the first stage of atherosclerosis, and it is suggested that expression of adhesion molecules in children can be greater than in adults. The aim of the study was to evaluate the concentration of soluble forms of adhesion molecules slCAM-1 and sVCAM-1 in children and adolescents with type 1 diabetes. The concentration of adhesion molecules was additionally assessed depending on metabolic compensation, complications, diabetes duration and family history of cardiovascular disease.

Material and methods: The study was carried out in 28 children and adolescents with type 1 diabetes, aged 10.5-18 years (mean 15.3), with diabetes duration 5-15 years (8.1); mean HbA1c level during last six months was 6-11.4% (8.2%). Control group included 16 healthy, slim children aged 11-18 years (15.5). slCAM-1 and sVCAM-1 levels were assessed by means of immunoenzymatic methods (Parameter Human soluble lCAM-1 Immunoassay, Parameter Human soluble VCAM-1 Immunoassay, R&D Systems).

Results: slCAM-1 concentration in diabetic children was 305 +/- 71 ng/dl and was significantly higher than in controls--262.1 +/- 59 ng/dl (p = 0.04). sVCAM-1 concentration in diabetic children was 499.5 +/- 162 ng/dl and did not differ from the controls--446.3 +/- 95 (ns). In 5 children with positive family history of cardiovascular disease we found significantly higher slCAM-1 level: 323 +/- 72 ng/dl vs 244 +/- 30 ng/dl in children with negative family history (p < 0.05). The level of slCAM was slightly higher in ill children with worse metabolic compensation (314 +/- 90 ng/dl in group with HbA1c > 8%, 322 +/- 84 ng/dl in group with HbA1c < 8% but > 7%, and 285 +/- 68 ng/dl in group with HbA1c < 7%). We found a significant correlation between HbA1c and slCAM-1 (r = 0.39, p = 0.014) as well as between BMI and sVCAM-1 (r = 0.39, p = 0.044).

Conclusions: 1. Elevated level of slCAM-1 in young diabetic patients correlates with metabolic compensation and positive family history of cardiovascular diseases. 2. sVCAM-1 level in diabetic children correlates significantly positively with body mass index (BMI). 3. Evaluation of adhesion molecules levels can be useful tool in the observation of the dynamic development of early phases of atherosclerotic process in young patients with type 1 diabetes.