The relationship between serum VEGF, albuminuria, cytokines. blood pressure and serum kreatinin in type 2 diabetic patients

ABSTRACTThe Relationship Between Serum Vegf, Albuminuria, Cytokines, Blood Pressure AndSerum Kreatinin In Type 2 Diabetic PatientsDiabetic microvascular complications are the major causes of morbidity and early mortalityin diabetes. Vascular endothelial growth factor (VEGF) is a potent multifunctional cytokinewhich plays a key role in the pathogenesis of diabetic microvascular complications.We examined the possible association of the serum vascular endothelial growth factor and proinflammatory cytokins with diabetic nephropathy and retinopathy in type 2 diabetes patients.In this study we anayzed 31 male and 38 female, total 69 individuals in the avarage age of56±8,8 years. Diabetes duration was 8,5±5,8 years . Patients are separated into four grups; control(gruop 1, n=12), normoalbuminurik diabetic (group 2, n=23), microalbuminurik diabetic (group3, n=21), macroalbuminurik diabetic (group 4, n=13). Serum vascular endothelial growth factor,tumor necrosis factor- α, interleukin-1, interleukin-6 and interleukin-10 concentrations weremeasured by elisa technique. In addition, biochemical measures, albumin to creatinine ratio(ACR) of the patients, eye check-up, ecocardiografic measures, blood pressure of patients weremeasured.We found that serum vascular endothelial growth factor is increased in three groups(group 2 [132,3 ± 112,2] , p<0,098 , group 3 [155,1±33,8] , p<0,074, group 4 [428,2±118,7],p<0,066). However, serum vascular endothelial growth factor concentration was not related to thedegree of albuminuria. Serum vascular endothelial growth factor level in patients withretinopathy (200,3±180,6 ng/l, n=34, p=0,048) was elevated as compared to those withoutretinopathy (126,2±107,1 ng/l, n=35). There was a positively corelation between HbA1c andserum vascular endothelial growth factor in three group (group 2 r=0,784 p<0,001, group3r=0,758, p<0,001, group 4, r=0,056). We determined an increase in the amount of interleukin-1in group 3 and group 4 (group 3 p=0,053, group 4 p<0,01). Morever, there was a positivelycorelation between HbA1c and serum interleukin-1 in group 3. We observed an importantincrease at the amount of tumor necrosis factor- α three in groups compared to controls (group 2<0,01, group 3, p<0,01, group 4, p<0,01).The results suggested that patients with diabetic nephropathy are not necessarily associatedwith an elevation of circulating serum vascular endothelial growth factor concentration.Glycaemic control influences vascular endothelial growth factor and cytokines serum levels.Microvascular complications is associated with marked increase of vascular endothelial growthfactor concentrations in the serum of patients with diabetic nephropathy.Key Words: Vascular endothelial growth factor, diabetic nephrophaty, cytokines, diabeticretinopathyIX