Circulating adhesion molecules and associations with HbA1c, hypertension, nephropathy, and retinopathy in the Treatment Options for type 2 Diabetes in Adolescent and Youth study

Background The Treatment Options for type 2 Diabetes in Adolescent and Youth study, a randomized clinical trial of three treatments for type 2 diabetes (T2DM) in youth, demonstrated treatment failure (defined as sustained HbA1c ≥8%, or inability to wean insulin after 3 months after acute metabolic decomposition) in over half of the participants. Given that binding of mononuclear cells to vascular endothelium, initiated by cellular adhesion molecules and chemokines, is an early step in vascular injury, we sought to evaluate (a) changes in cellular adhesion molecule levels during the trial; (b) effect of diabetes treatment; and (c) association of markers with HbA1c, hypertension, hypercholesterolemia, nephropathy, and retinopathy. Methods Participants (n = 515 of 699) that had baseline assessment of adhesion molecules (monocyte chemoattractant protein‐1 [MCP‐1], vascular cell adhesion marker [VCAM], intercellular adhesion marker [ICAM], and E‐Selectin) and at least one other assessment, measured at month 12, 24, or 36, were included. Results Over 1 to 3 years, significant increases in MCP‐1 and decreases in VCAM (both P