Measurement Of Molecular Markers Of Vascular Endothelial Cell Damage And Platelet Activation And Their Significance In Type 2 Diabetics

Objective Macrovascular and microvascular diseases are important chronic complication in diabetes , vascular endothelial function damage or dysfunction and platelet activation were regarded as early step in the development of atherosclerosis. Molecular markers of endothelial damage and platelet activation indicate not only contribute to the development and progression of vascular disease but also the increased risk of vascular disease (including microvascular and macrovascular )in patients with type 2 diabetes mellitus. This study is to investigate the changes and their clinical significances of plasma von Willebrand factor(vWF), thrombomodulin (sTM), soluble endothelial cell protein C receptor(sEPCR) and GMP-140 in patients with type 2 diabetes mellitus. Methods Plasma vWF, sEPCR , sTM, GMP-140 and urinary albumin excretion (UAE)were measured in 62 type 2 diabetics and 25 control subjects by enzyme-linked immunosolvent assay (ELISA), flow cytometric immunoflurescence and RIA , respectively .According to 24h urinary albumin excretion (24hUAE), 62 type 2 diabetics were divided into group A(n=27, 24h UAE <30mg) , group B(n=21, 24h UAE30 -300 mg ) and group C (n=14 , 24h UAE > 300 mg) . Results : (1)Compared with control group , plasma vWF, GMP-140(P<0.01) and sEPCR, sTM (P<0.001) parameters all increased significantly in 62 diabetics; (2) Compared with control group , plasma levels of vWF , sEPCR and GMP-140 increased, but had no obvious significance, plasma sTM level was elevated significantly in group A (P<0.05); Levels of vWF, GMP-140, sTM (P<0.01) and sEPCR (PO.001) all increased markedly in group B , and further increased in group C. (3) Plasma sEPCR was positivelyrelated to plasma GMP-140, vWF and sTM (P<0.001; P<0.01; P<0.001), plasma GMP-140 were positively related to 24hUAE, P<0.05 , plasma sTM , vWF and sEPCR also had significant positive relationship with 24hUAE , P<0.001 . Conclusion There existed endothelial cell damage and platelet activation in type 2 diabetics , even in patients with normoalbuminuria, which may contribute to in some extent the hyper-coagulant, hyper-aggregation and hyper-viscidity status in diabetics ; The increases of plamsa vWF, sTM , sEPCR and GMP-140 were related to endothelial cell damage and platelet activation and their severity. These factors levels were positively correlated with urinary albumin excretion and course of diabetes , they were the sensitivity and special markers for the vascular endothelial cell dysfunction and the platelet activation in diabetics.