Endocrine Abstracts

Introduction: Diabetic nephropathy (DN) is an important one of the complications and is detected in almost 30-40% of the patients with type 1 diabetes mellitus (T1DM). Besides the well known risk factors, endothelial dysfunction also plays a role in the pathogenesis of DN and diabetic retinopathy. Our aim was to determine flow mediated dilation measurements and serum soluable ET-1, ICAM-1, and VCAM-1 levels in T1DM patients with or without inceased albumin excretion and compare them with the control group.

Methods: We enrolled 73 patients with T1DM. Diabetic patients were divided into two subgroups according to microalbumin measurements in 24 h urine collections. Patients with microalbuminuria formed Group 1 and without microalbuminuria were defined as Group 2. We have also enrolled 40 subjets with similar sex and age distrubution as control group (Group 3). Serum ET-1, ICAM-1, and VCAM-1 levels were determined and FMD measurements were done in all individuals.

Results: Mean age, sex distrubition, presence of hypertension, serum LDL, and triglyceride levels were similar in all groups. Diabetic groups were similar in regard to glycemic control and disease duration. Mean FMD measurement was lower in diabetic groups compared to the control group. FMD was negatively correlated with age. We didn’t detect any difference between groups according to serum ET-1 levels. Median serum ICAM-1 level was higher in diabetic groups compared to the control group. Median serum VCAM-1 level was higher in the group of patients with microalbuimuria compared to the normoalbuinuric and control groups. Serum VCAM-1 level was found to be posively correlated with degree of urinary albumin excretion (P>0.001).

Conclusion: ICAM-1 and VCAM-1 are proinflammatory molecules that play an important role in pathogenesis of endothelial dysfunction. VCAM1 may be used as a predictive marker for risk stratification of nephropathy development and progression in T1DM.