relationship between urinary vascular endothelial growth factor and insulin like growth factor levels on diabetic nephropathy in patients with type 2 diabetes

ABSTRACT

Urinary Vascular endothelial growth factors [u VEGFs] as well as plasma insulin like growth factors [pIGFs] has been implicated in the pathogenesis of diabetes mellitus. This study was performed to determine whether alternations of urinary VEGFs and plasma IGFs are related to diabetic nephropathy in type 2 diabetic patients. We examined association of UVEGFs,pIGFs concentrations with fasting glucose level, glycemic control index [HbAlc%], urinary measured renal parameters i.e. creatinine, creatinine clearance and albumjnuria as well as lipogram parameters in 75 type 2 diabetic patients and 25 healthy controls. Study subjects were divided into four groups using urinary albumin to creahinine ratio [A/Cr]. We confirmed that [i] both urinary VEGFs and plasma IGFs showed remarkable increase in all diabetic groups with worsen A/Cr ratio, as compared with controls. [ii] Urinary VEGFs and plasma IGFs were increased in diabetic patients as long as glycemic control was not achieved [iii] Vascular endothelial growth factor in urine as well as plasma insulin like growth factors elevations were also revealed statistically direct positive correlation with glycemic control index, albuminuria as well as T.G.s elevation and HDL decreasing in lipogram parameters. Urinary VEGFs excretions as well as plasma IGFs increased during the earlier stage of diabetic nephropathy and were significantly correlated with urinary albumin excretion. This suggested that VEGFs may be used as a sensitive marker of diabetic nephropathy and for predicting disease progression