P 15: Low serum levels of L-Selectin as markers of silent myocardial ischemia and endothelial dysfunction in type 2 diabetic patients

Introduction In a pilot study we previously suggested that a low serum level of soluble L-Selectin, a protein involved in leucocyte adhesion, might be a marker of coronary artery disease in type 2 diabetic patients (T2D). The aim was to confirm this result in a larger cohort and to explore the association with endothelial dysfunction. Patients and Methods L-Selectin was measured in 364 (230 men) asymptomatic patients with T2D for 13.3±7.0 years, 59.9±8.5 years old, with at least one associated cardiovascular risk factor: hypertension 77.1%, dyslipidemia 70.8%, smoking 22.8%, incipient nephropathy 40.8%, peripheral occlusive arterial disease 13.0%, cardiac autonomic neuropathy (assessed on three standard tests) 74.0%. Silent myocardial ischemia (SMI) was detected by stress myocardial scintigraphy in 135 patients, and 45 of them had significant coronary stenoses on angiography. Results L-Selectin levels were lower in the patients with than in those without SMI (788±218 vs 853±244 ng/ml, p Conclusion Serum levels of L-Selectin are low in T2D patients with SMI. This change may account for leucocytes adhesion on activated endothelium, as suggested by the negative correlation between L-Selectin and albuminuria. The association hypertension - cardiac autonomic neuropathy may play a role in endothelium dysfunction.