ABSTRACT
A large body of evidence supports the contention that endothelial dysfunction is an important pathological basis for the metabolic or insulin resistance syndrome and may thus play a pivotal role in the pathogenesis of diabetes mellitus (type 1 and type 2) and related complications. Measurable levels of some soluble cellular adhesion molecules including E-selectin, intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) may refl ect the degree of endothelial activation (i.e., released by activated endothelial cells to the general circulation, these molecules are considered useful indicators of endothelial dysfunction/activation). Elevated levels of soluble cellular adhesion molecules have been associated with insulin resistance and its associated metabolic abnormalities including diabetic complications. Recent evidence from several large prospective studies has shown that elevated levels of endothelial biomarkers, especially E-selectin, VCAM-1, and
ICAM-1, were strong independent predictors of type 2 diabetes in populations with diverse ethnic backgrounds. Th is chapter aims to summarize both clinical and epidemiological studies relating plasma levels of endothelial adhesion molecules to diabetes mellitus and interpret these data in the context of emerging biological evidence. Th e available evidence indicates that elevated circulating levels of some, but not all, markers correlate not only with prediabetic insulin resistance and type 2 diabetes, but also with complications in both type 1 and type 2 diabetes. Future studies are warranted to evaluate the clinical utility of endothelial markers in comprehensively assessing and managing the development and prognosis of diabetes in the context of other diabetes biomarkers and traditional risk factors.
