Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis.
BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by endothelial dysfunction, increased thrombogenicity and abnormal inflammatory response. HYPOTHESIS: We hypothesizsed that insulin dependence/exogenous insulin administration may affect thrombotic/inflammatory status and endothelial func...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2007
|
| _version_ | 1826262210609938432 |
|---|---|
| author | Antoniades, C Tousoulis, D Marinou, K Papageorgiou, N Bosinakou, E Tsioufis, C Stefanadi, E Latsios, G Tentolouris, C Siasos, G Stefanadis, C |
| author_facet | Antoniades, C Tousoulis, D Marinou, K Papageorgiou, N Bosinakou, E Tsioufis, C Stefanadi, E Latsios, G Tentolouris, C Siasos, G Stefanadis, C |
| author_sort | Antoniades, C |
| collection | OXFORD |
| description | BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by endothelial dysfunction, increased thrombogenicity and abnormal inflammatory response. HYPOTHESIS: We hypothesizsed that insulin dependence/exogenous insulin administration may affect thrombotic/inflammatory status and endothelial function in patients with T2DM and coronary artery disease (CAD). METHODS: Fifty-five patients with T2DM + CAD (26 insulin-treated (INS) and 29 under oral biguanide + sulphonylurea (TABL)) were recruited. Endothelial function was assessed by gauge-strain plethysmography, and serum levels of inflammatory and thrombotic markers were determined by enzyme linked immunosorbent assay. RESULTS: There was no significant difference in endothelium-dependent dilation (EDD) between the study groups, while EDD was correlated with fasting glucose levels in both INS (r = - 0.776, p = 0.0001) and TABL (r = - 0.702, p = 0.0001). Patients in INS group had higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), monocyte chemoattractant protein (MCP-1) and vascular cell adhesion molecule (sVCAM-1), compared to TABL. However, TNF-alpha was negatively correlated with protein C (PrtC) only in INS (r = - 0.726, p = 0.01) but not in TABL group (r = - 0.066, p = 0.738). Similarly, sVCAM-1 was correlated with PrtC only among INS patients (r = - 0.451, p = 0.046) but not in TABL (r = 0.069, p = 0.727). In multivariate analysis, insulin dependence was a predictor of IL-6, TNF-alpha, MCP-1 and sVCAM-1 levels independently from the patients' demographic characteristics, the angiographic extend of CAD or the duration of diabetes. CONCLUSIONS: Insulin treatment in patients with type 2 diabetes mellitus affects the expression of inflammatory cytokines and subsequently modifies the thrombotic mechanisms in patients with coronary atherosclerosis, independently from the duration of diabetes and the extend of coronary artery disease. |
| first_indexed | 2024-03-06T19:32:48Z |
| format | Journal article |
| id | oxford-uuid:1e0c5106-bba8-4353-bc26-431e85cc67c7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:32:48Z |
| publishDate | 2007 |
| record_format | dspace |
| spelling | oxford-uuid:1e0c5106-bba8-4353-bc26-431e85cc67c72022-03-26T11:14:12ZEffects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1e0c5106-bba8-4353-bc26-431e85cc67c7EnglishSymplectic Elements at Oxford2007Antoniades, CTousoulis, DMarinou, KPapageorgiou, NBosinakou, ETsioufis, CStefanadi, ELatsios, GTentolouris, CSiasos, GStefanadis, C BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by endothelial dysfunction, increased thrombogenicity and abnormal inflammatory response. HYPOTHESIS: We hypothesizsed that insulin dependence/exogenous insulin administration may affect thrombotic/inflammatory status and endothelial function in patients with T2DM and coronary artery disease (CAD). METHODS: Fifty-five patients with T2DM + CAD (26 insulin-treated (INS) and 29 under oral biguanide + sulphonylurea (TABL)) were recruited. Endothelial function was assessed by gauge-strain plethysmography, and serum levels of inflammatory and thrombotic markers were determined by enzyme linked immunosorbent assay. RESULTS: There was no significant difference in endothelium-dependent dilation (EDD) between the study groups, while EDD was correlated with fasting glucose levels in both INS (r = - 0.776, p = 0.0001) and TABL (r = - 0.702, p = 0.0001). Patients in INS group had higher levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), monocyte chemoattractant protein (MCP-1) and vascular cell adhesion molecule (sVCAM-1), compared to TABL. However, TNF-alpha was negatively correlated with protein C (PrtC) only in INS (r = - 0.726, p = 0.01) but not in TABL group (r = - 0.066, p = 0.738). Similarly, sVCAM-1 was correlated with PrtC only among INS patients (r = - 0.451, p = 0.046) but not in TABL (r = 0.069, p = 0.727). In multivariate analysis, insulin dependence was a predictor of IL-6, TNF-alpha, MCP-1 and sVCAM-1 levels independently from the patients' demographic characteristics, the angiographic extend of CAD or the duration of diabetes. CONCLUSIONS: Insulin treatment in patients with type 2 diabetes mellitus affects the expression of inflammatory cytokines and subsequently modifies the thrombotic mechanisms in patients with coronary atherosclerosis, independently from the duration of diabetes and the extend of coronary artery disease. |
| spellingShingle | Antoniades, C Tousoulis, D Marinou, K Papageorgiou, N Bosinakou, E Tsioufis, C Stefanadi, E Latsios, G Tentolouris, C Siasos, G Stefanadis, C Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis. |
| title | Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis. |
| title_full | Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis. |
| title_fullStr | Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis. |
| title_full_unstemmed | Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis. |
| title_short | Effects of insulin dependence on inflammatory process, thrombotic mechanisms and endothelial function, in patients with type 2 diabetes mellitus and coronary atherosclerosis. |
| title_sort | effects of insulin dependence on inflammatory process thrombotic mechanisms and endothelial function in patients with type 2 diabetes mellitus and coronary atherosclerosis |
| work_keys_str_mv | AT antoniadesc effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT tousoulisd effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT marinouk effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT papageorgioun effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT bosinakoue effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT tsioufisc effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT stefanadie effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT latsiosg effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT tentolourisc effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT siasosg effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis AT stefanadisc effectsofinsulindependenceoninflammatoryprocessthromboticmechanismsandendothelialfunctioninpatientswithtype2diabetesmellitusandcoronaryatherosclerosis |