| Objective:To study the effect of the various glucose tolerance on the activation of theendothelial cells by measuring the serum soluble E-selectin (sE) concentrationins amongthe subjects with normal glucose tolerance (NGT) and with impaired glucose tolerance (IGT)and patients with type 2. diabetes mellitus(T2DM).Meanwhile to determine therelationships between the serum sE level and factors including age,gender,body massindex(BMI),waist circumstance (WC),waist-hip-rate (WHR),blood pressure,blood lipid,fasting plasma glucose(FPG),postprandial 2 hour plasma glucose(P2hPG),fastinginsulin(FIN),homeostasis model assessment for insulin resistance(HOMA-IR),glycatedhaemoglobin Alc(HbAlc).Contents:Forty-two patients with T2DM were recruited from the metabolic clinics at TianjinMedical University General Hospital. Oral 75 gram glucose tolerance test was done amongthe volunteers recruited by advertisement. According to the results of the test , wechoosed thirty-six subjects with NGT and thirty-eight cases with IGT randomly. Further,according to the HOMA-IR, the cases with IGT was divided into two subgroups, namelysubgroup with insulin resistance and without insulin resistance. Serum sE concentrationwas measured by enzyme linked immunosorbent assay(ELISA).Methods:All analysis were performed with SPSS11.5 software package. Normal distribution ofthe data was tested using Kolmegorov-Smirnov nonparametric test. Serum sE levels werelog transformed in order to achieve a normal distribution of the data Groups comparionswere performed with one way analysis of variance(post Levene test). Comparion of any twogroup among the groups were performed with SNK-q test.Analysis of covariance was usedto compare data after adjustment for other variables. Pearson' correlation and stepwisemultiple regression analysis were used to determine the relationships between the serum sE level and multifactors. Difference were considered statistically significent at P≤0.05.Results:1. The serum sE levelof T2DM was higher than that in NGT and IGT. The results were 46.48(21.66-68.54 ) ng/ml,7.46 (4.61-12.47) ng/ml,13.80 (8.77-32.02)ng/ml (P=0.000, P=0.000, respectively). The serum sE level was higher in cases with IGTthan that in NGT subjects (P=0.001). The result was unchanged after adjustment for BMI.2. According to HOMA-IR, the cases with IGT were derided into two subgroups, namelyIGT without insulin resistance and IGT with insulin resistance. There was difference inthe serum sE level of the NGT,subgroup of IGT without insulin resistance,subgroup ofIGT with insulin resistance and T2DM. The results were respectively 7.46 (4.61-12.47)ng/ml,11.65 (6.17-17.96)ng/ml,14.43 (10.64-33.18)ng/ml,46.48 (21.66-68.54)ng/ml. Amongthem, there was no difference between the NGT subjects and cases of IGT without insulinresistance (P=0.156), the serum sE level of cases of IGT with insulin resistance was higherthan that in NGT subjects and cases of IGT without insulinresistance (P=0.000. P=0.011, respectively), the T2DM' serum sE level was higher than thatin other three groups (P=0.000, P=0.000, P=0.020, respectively).3. IN the NGT subgroup whose average age was no more than fifty years old, there wasdifference in the serum sE level between the males and fenales (P=0.039), the results were6.74(4.98-9.65)ng/ml and 2.87 (2.11-4.61)ng/ml. However there was no difference in theserum sE level between the males and females in the NGT subgroup whose average age weremore than fifty years old, there was also no difference in the serum sE level betweenthe males and females in the IGT and T2DM subgroups whose average age were no more thanfifty years old, so did in the IGT and T2DM subgroups whose average age were more thanfifty years old(all P＞0.05).4. Whatever NGT,IGT,T2DM, serum sE level always correlated positively withBMI (r=0.379, P=0.023; r=0.433, P=0.007; r=0.346, P=0.025, respectively), but there wasno relationship between serum sE level and age,systolic blood pressure (SBP),diastolicblood pressure (DBP),total cholesterol (TC),triglycerides (TG),low density lipoprotein cholesterol (LDL-c),FPG,P2hPG,WHR(all P＞0.05). In NGT. group, serum sE level alsocorrelated negatively with high density lipoprotein chotesterol(HDL-c)(r=-0.446,P=0.006). In IGT group, serum sE level also correlated positively with WC(r=0.426,P=0.008),FIN (r=0.416, P=0.009),HOMA-IR (r=0.436, P=0.006). In T2DM group, serum sE levelalso correlated positively with WC(r=0.381, P=0.013),FIN(r=0.512, P=0.001),HOMA-IR(r=0.458, P=0.002) and HbAlc(r=0.482, P=0.001).5. Stepwise multiple regression analysis showed that in NGT group, HDL-c and BMIcorrelated independently with serum sE level and in IGT group, only HOMA-IR entered intoregression equation but in T2DM group, HbAlc,FIN and BMI were independently correlativefactors with serum sE level.Conclusions:1. Serum sE level increased gradually with the worsening of the glucose tolerance.2. In cases with IGT, it was insulin resistance that resulted in the activation ofendothelial cells.3. In NGT group, serum sE level was lower in premenopause females than that in maleswho had similary age.4. Whatever glucose tolerance, obesity always correlated positively with theactivation of endothelial cells. In NGT group, serum sE level also correlated negativelywith HDL-c. In IGT group, serum sE level also correlated positively with fat distributionand insulin resistance. In T2DM group, serum sE level also correlated positively withthe average level of blood glucose, besides fat distribution and insulin resistance.5. In NGT group, HDL-c and obesity correlated independently with serum sE level. InIGT group, only HOMA-IR affected serum sE level independently. In T2DM patients, HbAlc,BMI and FIN independently affected the serum sE level respectively.
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