Plasma levels of ICAM-1 and circulating endothelial cells are elevated in unstable types 1 and 2 diabetes.

OBJECTIVE: To investigate the expression and release of vascular cell-adhesion molecule (VCAM)-1, intercellular adhesion molecule (ICAM)-1, endothelial leukocyte adhesion molecule (ELAM)-1 and von Willebrand factor (vWF), as well as circulating endothelial cells (CEC) and circulating endothelial progenitor cells (CEPC), as markers of endothelial dysfunction in uncontrolled, well controlled types 1 and 2 diabetic patients and non diabetic patients.
METHODS: In this observational trans section study, soluble adhesion molecules concentrations were measured by enzyme linked immunosorbent assays and flow cytometry to detect circulating cells in 49 patients, stratified in 3 groups: G1: uncontrolled types 1 and 2 diabetic patients (n=16); G2: well controlled diabetic (types 1 and 2) patients (n=13); and G3: non diabetic patients (n=20), of whom a blood sample was obtained on admission.
RESULTS: ICAM-1 increased significantly in uncontrolled versus well controlled and non diabetic patients (721 vs. 702.45 vs. 473.46 ng/ml, p=0.016). In unstable diabetic patients, CEC were higher than in the well controlled ones (7.75 vs. 4.3/ml, p=0.386) whereas CEPC were lower in unstable diabetics (56.5 vs. 72/ml, p=0.068).
CONCLUSIONS: This study showed a continuous rise in ICAM-1 and CEC levels as stable, well controlled diabetic patients shift towards decompensation. In unstable diabetic patients, the relationship between CEC and CEPC can be represented as [CEC] alpha 1/[CEPC].