Association of vascular endothelial growth factor with symptomatic peripheral artery disease in the elderly diabetics

Abstract

Objective To investigate plamsa levels of vascular endothelial growth factor(VEGF)and its mRNA expression levels in peripheral blood mononuclear cells (PBMCs) from type 2 diabetes mellitus(T2DM) patients with peripheral artery disease (PAD) and their correlation with PAD among T2DM patients. Methods Total of 126 T2DM patients were enrolled from January 2009 to January 2012 in Tangshan Gongren Hospital in this study; and the patients were divided into three groups including T2DM patients without PAD (DM group, n=40), T2DM with intermittent claudication (IC group, n=46), and T2DM with critical limb ischemia (CLI group, n=40). Plasma level of VEGF and its expression level in PBMCs in the three groups were detected by enzyme-linked immunosorbent assay(ELISA) and real-time polymerase chain reaction(RT-PCR), respectively, and the cutoff value of VEGF to diagnose T2DM with PAD was evaluated.Statistical analysis were performed by using one-way analysis of variance, χ2 test, and nonparameter test for multiple-group comparisons. Results There was significant difference in plasma levels of VEGF and its mRNA levels in PBMCs among the three groups (F=37.87, 36.41, both P<0.05). Moreover, both plasma levels of VEGF and its mRNA levels in PBMCs were significantly increased in CLI group compared with those in IC group [(568±201) vs (392±144) ng/L, 4.47(2.20-9.06) vs 2.58 (1.21-5.50), both P<0.05]. The VEGF plasma level ≥345.58 ng/L for the diagnosis of T2DM with PAD was the cutoff value with the highest sensitivity and specificity.Plasma levels of VEGF and its mRNA levels in PMBCs were negatively correlated with ankle brachial index among DM group, IC group and CLI group(r=-0.495--0.319, all P<0.05). Conclusion VEGF is closely associated with PAD in diabetics. Key words: Diabetes mellitus, type 2; Aged; Vascular endothelial growth factor; Peripheral artery disease