ABSTRACT
Atherosclerotic cardiovascular complications are the major causes of morbidity and mortality in type 2 diabetes mellitus. Injury of endothelial cells has been postulated as the initial trigger of progression of atherosclerosis in diabetes mellitus. It has been hypothesized that HGF might contribute to the protection or repair of vascular endothelial cells. Therefore, this study was designed to find out how much type 2 diabetes with and without ischemic heart disease affect the level of HGF and to find out any relationship between the change in serum HGF and development of coronary atherosclerosis. HGF levels were measured by ELIZA in the serum of 16 healthy volunteers and 44 type 2 diabetic subjects.13 of them had ischemic heart disease with coronary atherosclerosis, other 15 had ischemic heart disease with normal coronary angiogram while the remaining 16 diabetic subjects has no ischemic heart disease and without any complications. IN addition to, ultrasonographic measurements of the combined thickness of the common carotid intima and media [CCA-IMT] was done to all subjects to examine early vessel wall changes in atherosclerosis. Serum HGF levels were statistically significantly decreased and the mean CCA-IMT were significantly increased in uncomplicated diabetic subgroup [group II] compared to controls [P<0.05] on the other hand, we found that serum HGF levels were statistically significantly increased and the mean CCA-IMT were significantly increased in other two diabetic subgroups [diabetics with ischemic heart disease] [group III and IV] compared to controls [P < 0.05, P<0.01] respectively. Also, we found that serum HGF levels and the mean CCA-IMT were statistically significantly increased in diabetics with ischemic heart disease and with coronary atherosclerosis compared to diabetic with ischemic heart disease and with normal coronary angiogram [P<0.05]. Clycozylated haemoglobin [HbAIC] was significantly increased in diabetic subgroups compared to controls [P<0.05, P<0.05 and P<0.01] respectively. And in diabetics with coronary atherosclerosis compared to those without [P<0.05]. HDL-C was significantly decreased in diabetic with ischemic heart disease and with coronary atherosclerosis compared to those without [P<0.05]. Significant negative correlation were obtained between serum HGF and each of HbA1c [r=-0.614, P<0.01] and CCA-IMT [r=-0.66, P<0.01] in uncomplicated diabetics and significant positive correlation between serum HGF and each of HbA1c [r=+0.62, P<0.01] and CCA-IMT [r+0.68, P<0.01] in diabetics with ischemic heart disease with and without coronary atherosclerosis. At the same time, we found significant positive correlation between CCA-IMT and each of age of diabetics [r=+0.43, P<0.05], duration of diabetes [r+0.41, P<0.05] and HbA1c [r=+0.71, p<0.01] in all diabetic subgroups. We can conclude that serum HGF decreased in uncomplicated diabetics and increased in diabetic with ischemic heart disease especially those with coronary atherosclerosis. increased serum HGF may be involved in the pathogenesis of atherosclerosis in type 2 diabetes and can be used as a useful test for predicting these atherosclerotic lesions. Treatment strategies to decrease HGF in type 2 diabetics complicated with atherosclerotic vascular disease by the use of growth modulating factors may prove to be useful to prevent and slow the progression of atherosclerosis in type 2 diabetes mellitus