Acta Univ Latv (2009) 753: 107–115

Alteration of serum adhesion molecules and cutaneous endothelium-dependent vasodilatation in insulin resistant obese patients

Abstract

Insulin resistance (IR) is associated with decreased endothelium-dependent vasodilatation. Adhesion molecules are regarded as endothelial dysfunction biomarkers, which are markedly upregulated in obesity-linked diseases, including coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM). The purpose of the study was to evaluate the relationships between IR, vascular cell adhesion molecule-1 (sVCAM-1), intercellular cell adhesion molecule-1 (sICAM-1), sEselectin, and endothelium-dependent vasodilatation in metabolic syndrome (MetS) patients who were categorized as having T2DM, both T2DM and CAD, or neither. Obese MetS patients with dyslipidemia were classified into three groups: 34 patients with T2DM (D), 20 patients with T2DM and CAD (DC), and 26 patients with MetS alone (M). Eighteen healthy subjects were selected as controls (C). The study groups were matched for age and sex. IR was assessed by HOMA-IR method, and serum sVCAM-1, sICAM-1, and sE-selectin levels were measured by xMAP technology. Laser Doppler imaging with iontophoretic application of 1% acethylcholine (LDI-Ach) solution was used for the evaluation of cutaneous endothelium-dependent vasodilatation in the hand. Serum levels of sVCAM-1, sICAM-1, and sE-selectin were significantly higher in the group of DC patients compared with the levels in other groups (p < 0.01), except for sICAM-1 in the D group. Also, sVCAM-1, sICAM-1, and sE-selectin concentrations were significantly correlated with HOMA-IR indexes (p < 0.0001). Only D and DC patient groups demonstrated a significant and similar decline in LDI-Ach marker compared to the group of healthy subjects (p < 0.001). LDI-Ach values were significantly correlated with HOMA-IR indexes, sVCAM-1, sICAM-1, and sE-selectin levels (p < 0.01). Our findings show that obese MetS patients with T2DM have more higher serum levels of adhesion molecules (sICAM-1, sVCAM-1, and sE-selectin), simultaneously with both higher IR and lower endothelium-dependent vasodilatation than those with MetS alone, and the presence of CAD in these patients is associated with greater changes in the endothelial dysfunction markers. IR was observed to be a closely related to endothelial dysfunction.