Chiarelli F, Spagnoli A, Basciani F, Tumini S, Mezzetti A, Cipollone F, Cuccurullo F, Morgese G, Verrotti A
Department of Medicine, University of Chieti, Italy.
Diabet Med. 2000 Sep;17(9):650-6. doi: 10.1046/j.1464-5491.2000.00350.x.
To evaluate serum levels of vascular endothelial growth factor (VEGF) in a large group of children, adolescents and young adults with Type 1 diabetes mellitus to investigate whether increased VEGF concentrations are associated with long-term glycaemic control and microvascular complications.
The study involved 196 patients with Type 1 diabetes mellitus (age range 2-24 years, onset of diabetes before the age of 12 years, duration of disease longer than 2 years), without clinical and laboratory signs of microvascular complications; they were divided into three groups (group 1 - n = 37, age < 6 years; group 2 - n = 71, age 6-12 years; group 3 - n = 88, age > 12 years). Fifty-three adolescents and young adults (age 16.1-29.7) with different grades of diabetic retinopathy and microalbuminuria were also selected (group 4). A total of 223 healthy controls were matched for age and sex with each group of patients with diabetes mellitus.
VEGF serum levels were significantly increased in pre-school and pre-pubertal children with diabetes as well as in pubertal patients compared to controls. VEGF concentrations were markedly increased in adolescents and young adults with microvascular complications compared with both healthy controls and diabetic patients without retinopathy or nephropathy. Multivariate analysis showed that elevation of VEGF in serum was an independent correlate of complications. One-year mean HbA1c values were significantly correlated with VEGF concentrations (r = 0.372; P < 0.01). Children with HbA1c levels greater than 10% had significantly higher VEGF concentrations when compared with matched patients whose HbA1c levels were lower than 10%. In poorly controlled diabetic children (HbA1c > 10%), long-term (2 years) improvement of glycaemic control (aiming at HbA1c < 7%) resulted in a significant reduction of VEGF levels.
VEGF serum concentrations are increased in prepubertal and pubertal children with diabetes. Glycaemic control influences VEGF serum levels. Severity of microvascular complications is associated with marked increase of VEGF concentrations in the serum of these patients.
评估一大群1型糖尿病儿童、青少年和青年的血清血管内皮生长因子（VEGF）水平，以研究VEGF浓度升高是否与长期血糖控制及微血管并发症相关。
该研究纳入了196例1型糖尿病患者（年龄范围2 - 24岁，糖尿病发病年龄在12岁之前，病程超过2年），且无微血管并发症的临床及实验室体征；他们被分为三组（第1组 - n = 37，年龄<6岁；第2组 - n = 71，年龄6 - 12岁；第3组 - n = 88，年龄>12岁）。还选取了53例患有不同程度糖尿病视网膜病变和微量白蛋白尿的青少年及青年（年龄16.1 - 29.7岁）（第4组）。共有223名健康对照者在年龄和性别上与每组糖尿病患者相匹配。
与对照组相比，糖尿病学龄前和青春期前儿童以及青春期患者的VEGF血清水平显著升高。与健康对照者以及无视网膜病变或肾病的糖尿病患者相比，患有微血管并发症的青少年和青年的VEGF浓度明显升高。多变量分析表明血清VEGF升高是并发症的独立相关因素。一年平均糖化血红蛋白（HbA1c）值与VEGF浓度显著相关（r = 0.372；P < 0.01）。与糖化血红蛋白水平低于10%的匹配患者相比，糖化血红蛋白水平大于10%的儿童的VEGF浓度显著更高。在血糖控制不佳的糖尿病儿童（HbA1c > 10%）中，长期（2年）改善血糖控制（目标为HbA1c < 7%）导致VEGF水平显著降低。
糖尿病青春期前和青春期儿童的VEGF血清浓度升高。血糖控制影响VEGF血清水平。微血管并发症的严重程度与这些患者血清中VEGF浓度的显著升高相关。
