| Cardiovascular disease is the leading cause of mobility and mortality in patients with type 2 diabetes mellitus (DM). The prevelence of coronary heart disease is two to three times higher in type 2 diabetic patients than that in general population. However, the pathogenesis of macrovascular complications in diabetes may be complicated, and both direct and indirect mechanisms may be implicated. Since Fabricant succeeded in virus-inducing atherosclerotic lesions in chickens by Marek Disease Virus(MDV), many studies have explored that the atherosclerosis (AS) is associated with human cytomegalovirus (HCMV) infection. But the relationship between HCMV infection and plasma endothelin (ET) and serum tumor necrosis factor(TNF) which are closely related to the pathogenesis of the AS is unclear. We measured anti-HCMV-IgG and anti-HCMV-IgM , the levels plasma ET and serum TNF- a in patients withtype 2 diabetes mellitus, in order to evaluate the association between HCMV infection and AS and explore the possible role of ET and TNF- a in the pathogenesis of AS in diabetic patients and the relationship between HCMV infection and concentrations of plasma ET and serum TNF-a .Research design and methods1. Subjects1.1 DM group: 68 patients of type 2 DM(male 41, female 27, age 52.7 ?12.8 years) with normotension, who met the criteria of the WHO (1985) for diagnosis and classification of diabetes, participated in the study. Of the cases, 21 had evidence of AS (angina 13, myocardial infarction 2, cerebral thrombosis 5, atherosclerosis of lower limb 1 ), 47 had no obvious evidence of AS based on clinical examination, eletrocardiogram and standard laboratory tests.1.2 Control group: A total of 20 healthy persons (male 11, female 9, age 53.5 + 8.2 years ) were recruited to the study acting as control group. All control subjects take no medications in recent 2 months . 2. MethodsSpecial antibodies to HCMV (IgM,IgG) were measured by enzyme-linked immunosorbent assay (ELISA) . The concentrations of serum TNF-a and plasma ET were determined by radio-immunological assay(RIA).3. Statistical analysisStatistical analysis was preformed by using the SSPS10. 0 software system. Data of antibodies to HCMV were expressed as frequency. between-group differences were assessed by x2 analysis. All variable of ET and TNF concentrations were normally, and the data were expressed as means SD. T tests were used to determine differences in means. A P value of <0.05 was considered significant. Relationships between variables were analyzed by rank correlation coefficient.Results1. Compared with controls (n=20), patients (n=68) with type 2 DM had a significantly higher positive rate of IgM antibodies to HCMV [45. 59%(31/68) in 2 DM patients and 10%(2/10) in controls, respectively, x2 =8.53, p=0. 004 ],but no difference was found in anti-HCMV IgG antibodies [80.0%(16/20) and 92.65% (63/68), respectively, x2 =2.69, p=0. 101] between two groups .2.The diabetic patients with AS had a significantly higher prevalence of anti-IgM to HCMV than DM with no-AS group [ 57.1%(12/21) and 40.4% (19/47), respectively, x2=2.63, p=0.045], but the prevalence of anti-IgG to HCMV did not have the similar change[95.2%(20/21) and 91.5% (43/47), respectively, x2=0.299, p=0.584].3.Patients with type 2 DM had significantly higher levels of plasma ET (pg/ml) and serum TNF - a (ng/ml)than controls. (ET: 2 DM 68.68±17.12 vs controls 49.04±14.36, t=4. 66, p=0. 000; TNF-a : 1. 79?. 43 vs 1.32 ± 0.41, t=4. 31, p=0.000).4. The levels of ET and TNF-a in type 2 DM with AS group were significantly higher than those in no-AS subgroup. (ET:AS 86. 77± 15. 19 vs no-AS 60. 95 ± 10. 49, t=8. 301, p=0. 004; TNF: 2. 01 ±0. 45 vs 1. 68 ± 0.38, t = 3. 003, p=0. 003)5. Compared with the diabetic patients with negative anti-IgM to HCMV , the patients with positive anti-IgM had a significantly higher levels of plasma ET (75. 10±19. 17 vs 63. 29±13. 7...
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