Abstract

Increasing evidence in both experimental and clinical studies suggests oxidative stress (OS) plays a major role in the pathogenesis of type 2 diabetes mellitus and its complications. In a physiological condition, appropriate levels of ROS, generated either in restricted amounts or transient fashion, are required to promote physiological angiogenesis and homeostatic maintenance of healthy vasculature. Uncontrolled continuous ROS production will ultimately contribute to pathology and cause tissue damage. One of the most important proangiogenic factors is vascular endothelial growth factor (VEGF) which plays a key role in diabetic endothelial dysfunction, which ultimately leads to pathogenesis of vascular complications. As VEGF is released by activated platelets, hence platelet activation could be the source of VEGF in plasma samples. Increased platelet activity is emphasized to play a role in the development of vascular complications in T2DM patients and platelet volume, a marker of the platelet function and activation, is measured as mean platelet volume (MPV). Therefore, we aimed to investigate the association between plasma VEGF levels and MPV levels that may lead to vascular complications. A case-control study of one hundred patients with T2DM (n = 100) and thirty control subjects (n = 30) were screened from different areas of West Bengal. All procedures were done with the informed consent of participants. Elevated VEGF level was found in T2DM patients (526.8 ± 34.3 pg/ml) compared to healthy controls (317.9 ± 12.9 pg/ml) which was statistically significant. T2DM patients had higher MPV (12.5 ± 0.2 fl) compared to controls (11.4 ± 0.2 fl). Thus the present study showed a significant association between VEGF level in plasma and MPV indicating the severity of vascular complications. Hence, in conclusion, it suggested that VEGF levels along with MPV are a reliable biomarker for evaluating the development and progression of vascular complications.

Highlights

  • Type 2 diabetes mellitus (T2DM), the most frequent subtype of diabetes, comprises a complex heterogeneous group of metabolic diseases characterized by high levels of blood glucose and impaired insulin action and/or insulin secretion

  • In conclusion, it suggested that vascular endothelial growth factor (VEGF) levels along with mean platelet volume (MPV) are a reliable biomarker for evaluating the development and progression of vascular complications

  • Income level, which is a major reflection of socioeconomic status (SES), has a close association with the adverse health effects including the incidence of T2DM

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Summary

Introduction

Type 2 diabetes mellitus (T2DM), the most frequent subtype of diabetes, comprises a complex heterogeneous group of metabolic diseases characterized by high levels of blood glucose (hyperglycaemia) and impaired insulin action and/or insulin secretion. The incidence of T2DM varies substantially from one geographical region to the other as a result of environmental and lifestyle risk factors [3]. One of the factors associated with diabetic complications is the process of non-enzymatic glycation of proteins, lipids and nucleic acids, with subsequent formation of advanced glycation end products (AGEs) [4]. One of the main consequences of this adverse action is the formation of oxidative stress (OS). Formation of glycation end products leads to OS and subsequent DNA damage via the oxidation of DNA bases and sugar-phosphate binding sites. OS represents an imbalance between the production and manifestation of reactive oxygen species (ROS) especially free radicals and a biological system’s ability to detoxify the reactive intermediates or to repair the resulting damage

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