Vascular endothelial growth factor and diabetic nephropathy in type-2 diabetic patients

ABSTRACT

Diabetes usually accompanied with multiple complications affecting both the microvasculature and macrovasculature. Vascular endothelial growth factor [VEGF] has been implicated in the pathogenesis of diabetic nephropathy. This study was designed to investigate serum and urinary VEGF in type-2 diabetic patients and assess whether serum and urinary VEGF levels are related to the severity of diabetic nephropathy. The study included 80 type-2 Egyptian diabetic patients [46 female, 34 male] attending the outpatient clinics of NIDE and 30 normal controls. Blood pressure, BMI, FBS, HBA1c, lipid profile, urea, creatinine, uric acid, microalbuminurea and VEGF [serum and urine] were measured. Fundus examination, chest X-ray and ECG were performed for all subjects and echocardiography was done when indicated. There was a significant increase in plasma VEGF concentrations in diabetic patients than in normal controls. Patients with higher levels of serum VEGF concentrations had a significant increase in systolic BP, diastolic BP, FBS, HbA1c, serum creatinine, albumin/creatinine ratio and retinopathy than those with lower levels of serum VEGF concentrations. There was also a significant increase in urinary VEGF concentrations in diabetic patients than in normal controls. Urinary VEGF levels appeared to be positively correlated with both urinary ACR and serum creatinine. These data demonstrate the ability to reveal new markers for diabetic nephropathy, an important step forward in advancing accurate diagnosis and understanding of disease mechanisms