ABSTRACT
The role of different growth factors in both micro and macroangiopathic complications of diabetes had not been explored enough. One of the most relevant growth factor in diabetic foot syndrome patients [DFU] is the vascular endothelial growth factor [VEGF]. Some therapeutic trials has been started based on the hypothesis that administration of VEGF will lead to stimulation of angiogenesis and increased collaterals both in peripheral arterial disease [PAD] and coronary artery disease [CAD] specially in inoperable patients. To study plasma VEOF levels in diabetic patients and its relation to PAD in the different subtype of Diabetic foot ulcer whether isehemic, neuropathic or neuroischemic. Sixty nine patients with type 2 diabetes were recruited into this study; 38 had DFU and 31 patients without foot ulceration [diabetic group], together with 24 healthy subjects of matched age and sex as a control group.Ankle brachial pressure was assessed by Doppler ultrasound. The diagnosis of peripheral neuropathy was based on complete neurological assessment of both lower limbs with special stress on pressure perception evaluated by using 10 gram monnfllament [5.07 SW monofilament]. Angiography examination of lower limb vessels was done. Plasma level of VEGF was estimated. Serum VEOF was significantly increased in DFIJ patients and in patients with ischemic ulcers. The increase was more pronounced in latter than the former group. The elevated plasma VEOF levels are unlikely to be explained by other confounding variables such as variability in metabolic control, concomitant retinopathy or increased urinary albumin excretion. Whether the high plasma levels of VEGF could affect clinical outcome or have an impact on response to therapy as it is the case in patients with acute coronary syndrome will definitely merit further studies