Role of Soluble P-Selectin Among Type 2 Diabetic Patients with and Without Coronary Heart Disease
Type 2 diabetes mellitus (T2DM) is associated with a marked increase in the risk of coronary heart disease. Platelets play a significant role in coronary artery disease (CAD). P-selectin is a component of the platelet granule membrane that is expressed on the platelet surface membrane and shed into the plasma as sP-selectin on platelet activation. The current study was performed to investigate the association of soluble P-selectin with inflammatory marker high sensitivity C-reactive protein (hsCRP), lipid profile and glycemic control among type 2 diabetic patients with and without coronary heart disease. This study included 31 diabetic patients with coronary artery disease (group I), 29 healthy subjects as control group (group II), and 28 diabetic patients without coronary artery disease (group III). The age and sex of diabetic groups were matched with normal control group. Glucose, HbA1c, lipid profile, hsCRP and sP-selectin were measured. The levels of glucose, HbA1c, total cholesterol, triacylglycerol, LDL-c, hsCRP and sP-selectin level were significantly higher in the diabetic group with coronary artery disease than in the control group and the diabetic group without coronary artery disease. The level of HDL-c was significantly lower in the diabetic group with coronary artery disease than in the control group and the diabetic group without coronary artery disease. There was a significant positive correlation between level of sP-selectin and duration of CAD diabetic patients with coronary artery disease. Also there was a significant positive correlation between sP-selectin and duration of diabetes mellitus in both diabetic groups with and without coronary artery disease. ROC curve analysis for hsCRP and sP-selectin indicated that, sP-selectin had higher sensitivity and specificity than hsCRP in diabetic patient with coronary artery disease. In conclusion, measurement of soluble P-selectin seems more helpful marker of impending coronary artery insult in diabetic patients and had higher diagnostic value than hsCRP in diabetic patient with coronary artery disease.
Keywords: Type 2 diabetes mellitus, coronary artery diseases, hsCRP, P-selectin