E-Selectin as an Early Atherosclerosis Marker in Prediabetes

Abstract Background: Activation of endothelial dysfunction cascade and procoagulant pathways are one of the main pathophysiological mechanisms that leads to beta cell dysfunction, insulin resistance and vascular complications in prediabetes and diabetes. The present study aimed to investigate the relation between E-selectin and CIMT in prediabetic patients. Methods: Seventy five patients, who were diagnosed with prediabetes on 75gr oral glucose tolerance test (OGTT) based on ADA criteria, were included in the present study. Seventy five healthy volunteers were included as the control group. The patient and the control groups were examined in terms of E -selectin and fasting insulin levels. CIMT was measured by B-mode ultrasonography and HOMA-IR was calculated. Results: The mean E-selectin level was 35.19(9.56 – 118.46) ng/mL in the patient group and 16.80(1.55 – 116.62) ng/mL in the control group. The difference between the groups was statistically significant (P = 0.02). A significant positive correlation was found between E-selectin and HbA1c (r= 0.292, P=0.014), and HOMA-IR (r= 0.301,P=0.011) in the prediabetic group. Conclusion: We found that E -selectin level, which is one of the markers of endothelial dysfunction, was increased in prediabetes. This result supports the idea that endothelial dysfunction and early stage atherosclerosis start in the prediabetic period. Ozet Amac: Endotel disfonksiyonu kaskadi ve prokoagulan yolaklarinin aktivasyonu, prediyabet ve diyabette beta hucre fonksiyon bozukluguna, insulin direncine ve vaskuler komplikasyonlara yol acan ana patofizyolojik mekanizmalardan biridir. Bu calismada prediyabetli hastalarda E-selektin ve CIMT arasindaki iliskiyi arastirmak amaclanmistir. Yontem: ADA kriterlerine gore 75gr oral glukoz toleran testi (OGTT) ile prediyabet tanisi konan 75 hasta calismaya dahil edildi. Yetmis bes saglikli gonullu de kontrol grubu olarak degerlendirildi. Hasta ve kontrol gruplari E-selektin ve aclik insulin duzeyleri acisindan incelendi. CIMT, B-mod ultrasonografi ile olculdu ve HOMA-IR hesaplandi. Bulgular: Hasta grubunda ortalama E-selektin seviyesi 35.19 (9.56 - 118.46) ng / mL ve kontrol grubunda 16.80 (1.55 - 116.62) ng / mL idi. Gruplar arasindaki fark istatistiksel olarak anlamliydi (P = 0,02). Prediyabetik grupta E-selektin ile HbA1c (r = 0.292, P = 0.014) ve HOMA-IR (r = 0.301, P = 0.011) arasinda anlamli bir iliski bulundu. Sonuc: Prediyabette endotel disfonksiyonunun belirteclerinden biri olan E-selektin duzeyinin arttigini bulduk. Bu sonuc endotel disfonksiyonunun ve erken evre aterosklerozun prediyabetik donemde basladigi dusuncesini desteklemektedir.