| Patients with diabetes mellitus have an increased prevalence of vascular disease. Pathologic thrombosis associated with atherosclerotic plaque rupture is a major cause of morbidity and mortality. Platelets are intimately involved in the initiation and propagation of thrombosis. Evidence suggests that platelets from patients with type2diabetes have increased reactivity and baseline activation compared to healthy controls, and cardiovascular disease increased2-4times in T2DM patients, and the seriousness of vascular impairment has been greatly increased. Therefore, the prevention of early atherosclerosis in T2DM has become a current research hotspot.Objective:The aim of the study was to investigate levels of soluble P-selectin (sP-selectin) and soluble CD40L (sCD40L) in subjects with different glucose metabolism and analyze its association with metabolic indexes, i. e. body mass index(BMI),insulin resistance index, glucose, serum lipids, and analyze the correlation and relevant factors.Methods:90subjects were collected from May2011to August2011in Qilu Hospital of Shandong University,75g oral glucose tolerance test was undertaken with fasting and2hour plasma glucose(2hPG). Glucose tolerance status was defined as normal, IFG or IGT according to the criteria of the American Diabetes Association. Normal glucose tolerance (NGT) was defined as fasting plasma glucose below5.6mmol/L and2-h value in the75g OGTT less than7.8mmol/L1. IFG was defined as having fasting plasma glucose5.6-7.0mmol/L1and normal OGTT. IGT was defined as having fasting plasma glucose below5.6mmol/L and2-h value in the OGTT between7.8-11.0mmol/L.; The predibetes group consisted of30subjects male in16cases, and female in14cases, average (49.33±6.39) years,(IFG/IGT, n=30);T2DM group(FPG≥7. Ommol/L and2hPG≥11.1mmol/L) consisted of30subjects, male in12cases, and female in18cases, average (52.87±10.97) years.30healthy person with abnormal glucose tolerance were selected as control group, male in13cases, and female in17cases, average (48.43±8.05) years.. Exclusion criterion:hypertension, heart cerebrovascular disease, family type hyperlipidemia and connective tissue diseases were excluded; the other effects of sugar metabolism disorders were eliminated, such as hypercortisolism, pituitary growth cell tumor, pheochromocytomas; acute infection, chronic depleting diseases with cardiac insufficiency, severe liver and renal insufficiency were removed. Subjects were not taking vascular active substance and lipid-lowering medication. Age, sex, the histories of smoking and drinking, height, weight, systolic (SBP), diastolic blood pressure (DBP) waistline (WC), hip circumference (HC) of all the subjects were recorded, and body mass index (BMI) and waist-hip ratio (WHR) were calculated separately. FBG, blood lipid, and P2hBG were observed by enzyme technique. Insulin (INS) was determined by chemoiluminesence immunoassay, while ELISA was applied to detect sCD40L、sP-selectin.Insulin resistance(IR).Results:1. sCD40L and sP-selectin levels in pre-diabetes and T2DM group were significant higher compared with NC group (P<0.05).2. sP-selectin level was positively correlated with FPG,TG,TC,FINS,LDL-C, HbAlc and HOMA-IR, and negatively correlated with HDL-C(P<0.05).Furthermore, sCD40L level was positively correlated with FPG, BMI, and HbA1c(P<0.05). However, sCD40L level was not associated with TG, TC, FINS and BP (P>0.05)Conclusions:1.The sCD40L and sP-selectin levels significantly increase in pre-diabetes and diabetes subjects, which suggest platelet activation has occurred during pre-diabetic stage. 2. sCD40L and sP-selectin levels in T2DM group were significant higher compared with pre-diabetes group, which suggest platelet activation would developed as the rise of blood glucose level。3. sP-selectin level was positively correlated with FPG, TG, TC, FINS, LDL-C,sCD40L level was positively correlated with FPG, BMI,which sugguest FPG,BMI and so on may activate platelets and increase the state of coagulation. |
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