© 2002 Diabetes UK. Diabetic Medicine, 19, 57– 64 57 Correspondence to: Dr Takahiko Kawamura, Research and Consultation Department of Health Service Centre, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, Nagoya 455-8530, Japan. E-mail: kawamura.hsc@chubuh.rofuku.go.jp Abstract Aims To investigate the effect of smoking on soluble adhesion molecules in middle-aged diabetic patients. Methods One hundred out-patients with Type 2 diabetes and 100 age- and sex-matched non-diabetic subjects without clinical macrovascular disease were selected. Soluble serum levels of adhesion molecules were analysed using enzyme immunoassay. Carotid atherosclerosis was assessed using an ultrasound system. Results When compared with non-diabetic subjects, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), and sE-selectin were found at significantly high levels in diabetic patients and significantly higher levels of sICAM-1, sE-selectin, and sP-selectin were observed in current smokers than never-smokers among diabetic or non-diabetic subjects, respectively. The combined, but not enhanced, effects of diabetes mellitus and smoking were observed in sICAM-1 and sE-selectin levels. Additionally, levels of sICAM-1 (P < 0.05) and sE-selectin (P < 0.01), but not sP-selectin, were high in ex-smokers when compared with never-smokers among diabetic patients. Diabetic smokers were also found to have marked carotid atherosclerosis, which was related to increased levels of sICAM-1. Conclusions Our present study shows that levels of adhesion molecules were higher in diabetic smokers than diabetic non-smokers or non-diabetic smokers, and that cessation after chronic smoking did not restore the levels of sICAM-1 and sE-selectin, though sP-selectin levels were restored. These data suggest a possible mechanism for accelerated atherosclerosis induced by smoking in patients with diabetes. Diabet. Med. 19, 57– 64 (2002) Keywords cigarette smoking, adhesion molecules, carotid atherosclerosis, Type 2 diabetes mellitus Abbreviations sICAM-1, soluble intercellular adhesion molecule-1; sVCAM-1, soluble vascular cell adhesion molecule-1; sE-selectin, soluble E-selectin; sP- selectin, soluble P-selectin; IMT, intima and media thickness; FBG, fasting blood glucose Blackwell Science, Ltd Oxford, UK DME Diabetic Medicine 0742-3071 Blackwell Science Ltd, 2002 January 2002 19 1 8 Original Article Original article Cigarette smoking in diabetic patients N. Takuchi et al. The effect of cigarette smoking on soluble adhesion molecules in middle-aged patients with Type 2 diabetes mellitus N. Takeuchi*, T. Kawamura*†, A. Kanai‡, N. Nakamura*, T. Uno*, T. Hara*, T. Sano*, N. Sakamoto*, Y. Hamada‡, J. Nakamura‡ and N. Hotta‡ *Department of Metabolism and Endocrine Internal Medicine and †Research and Consultation Department of Health Service Centre, Chubu Rosai Hospital, and †Third Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan Accepted 30 June 2001