Biomedical Engineering Reference
In-Depth Information
sectional. Nevertheless, i ndings from prospective data, though limited, have been
consistent with those from cross-sectional studies, indicating that circulating levels
of endothelial adhesion molecules may add signii cantly to clinical risk stratii cation
and prognostic information for type 2 diabetes. Such i ndings, coupled with a large
body of experimental work, advance our understanding of the pathophysiological
role of endothelial dysfunction in the development and progression of diabetes
mellitus. Although further research is needed, the assessment of circulating
levels of endothelial adhesion molecules may have clinical value in identifying
individuals who are at high risk and for whom pharmacological therapy is justii ed
for diabetes risk reduction.
SUMMARY
• Early endothelial dysfunction is a common antecedent of the metabolic or
insulin resistance syndrome.
• Elevated circulating levels of some endothelial adhesion molecules
rel ect structural microvascular changes related to the pathophysiological
processes of impaired insulin action and secretion.
• Prospective data indicate that endothelial biomarkers, particularly
E-selectin, may independently predict the risk of type 2 diabetes.
• Circulating levels of endothelial adhesion molecules appear to have
signii cantly clinical prognostic value beyond inl ammatory marker-CRP
in predicting future risk of type 2 diabetes and diabetic complications.
• h e clinical utility of assessing these adhesion molecules for diabetes risk
stratii cation and management deserves further investigation.
Abbreviations
AGEs
advanced-glycation end products
CRP
C-reactive protein
CVD
cardiovascular disease
DPS
h e Finnish Diabetes Prevention Study
GDM
gestational diabetes mellitus
HbA1c
hemoglobin A1c
ICAM-1
intercellular cell adhesion molecule 1
NHS
the Nurses' Health Study
PKC
protein kinase C
VCAM-1
vascular cell adhesion molecule 1
WHI-OS
h e Women's Health Initiative-Observational Study
