Serum levels of endothelial monocyte activating polypeptide-II in type 1 diabetes patients with microangyopathy and arterial hypertention

Abstract

Aim. To determine the serum level of endothelial monocyte-activating polypeptide-II (EMAP-II), a marker of endothelial dysfunction, in patients with type 1 diabetes and microangiopathy and to study the association of arterial hypertension with the level of this factor and its relationship with the endothelium-dependent dilatation and other risk factors for cardiovascular disease. Materials and methods. We examined 23 patients with type 1 diabetes, microangiopathy and arterial hypertension; 10 patients with type 1 diabetes and microangiopathy without hypertension; and 28 healthy control subjects. Serum levels of EMAP-II were determined using immunoenzyme assay. Data were presented as means ± SD. Statistical analysis was performed using the Student's t-test, Spearman's rank correlation coefficient and multiple regression analysis. Results. We found an increase in the serum level of EMAP-II in patients with type 1 diabetes, microangiopathy and arterial hypertension compared with the control group (5.23 ± 1.66 ng/ml and 1.25 ± 0.76ng/ml; respectively, p < 0.01) and with the group of patients with diabetes but without hypertension (5.23 ± 1.66 ng/ml and 3.63 ± 1.9 ng/ml; respectively, p < 0.01). In addition, the level of EMAP-II correlated with key markers of carbohydrate and lipid metabolism and inversely correlated with endothelium-dependent dilatation (p < 0.05). Conclusion. The changes in EMAP-II serum levels could reflect an endothelial dysfunction in patients with type 1 diabetes as well as microangiopathy and arterial hypertension. Arterial hypertension, hyperglycaemia and dyslipidaemia appear to be significant contributing factors to the elevation of EMAP-II levels.