Kim Hye Won, Ko Gang Jee, Kang Young Sun, Lee Mi Hwa, Song Hye Kyoung, Kim Hyoung Kyu, Cha Dae Ryong
Department of Internal Medicine, Korea University, Ansan City, Kyungki-Do, Korea.
Nephrology (Carlton). 2009 Oct;14(7):681-8. doi: 10.1111/j.1440-1797.2009.01085.x.
Vascular endothelial growth factor (VEGF) is important in the pathogenesis of diabetic microvascular complications and the genetic polymorphism of this gene may contribute to the development and progression of diabetic microvascular complications. In this study, we investigated whether a genetic polymorphism of VEGF is associated with diabetic complications.
A total of 398 type 2 diabetic patients and 526 healthy controls were enrolled. The study subjects were divided based on the state of nephropathy, retinopathy and neuropathy. The VEGF 936 C/T polymorphism was evaluated using standard PCR techniques, and plasma and urinary levels of VEGF were determined by enzyme-linked immunosorbent assay.
There was no difference in VEGF genotype distribution between the control and diabetic patients based on the state of diabetic nephropathy and neuropathy. However, a higher frequency of the TT genotype was observed in patients with proliferative diabetic retinopathy. Additionally, plasma levels of VEGF were significantly higher in the TT genotype. However, urinary levels of VEGF did not show a significant relationship with the VEGF genotype. Urinary VEGF levels showed a significant relationship with urinary albumin excretion, proteinuria, serum creatinine level and creatinine clearance, as well as fasting blood glucose levels, postprandial 2 h glucose levels and C-reactive protein.
Our study suggests that the 936 C/T polymorphism of the VEGF gene may be an important factor determining plasma VEGF levels and that its polymorphism is related with diabetic retinopathy. Urinary levels of VEGF are not associated with plasma VEGF levels and associated with the stage of diabetic nephropathy.
血管内皮生长因子(VEGF)在糖尿病微血管并发症的发病机制中起重要作用,该基因的遗传多态性可能有助于糖尿病微血管并发症的发生和发展。在本研究中,我们调查了VEGF的遗传多态性是否与糖尿病并发症相关。
共纳入398例2型糖尿病患者和526例健康对照。研究对象根据肾病、视网膜病变和神经病变的状态进行分组。采用标准PCR技术评估VEGF 936 C/T多态性,通过酶联免疫吸附测定法测定血浆和尿液中VEGF的水平。
根据糖尿病肾病和神经病变的状态,对照组和糖尿病患者之间VEGF基因型分布无差异。然而,在增殖性糖尿病视网膜病变患者中观察到TT基因型的频率较高。此外,TT基因型患者的血浆VEGF水平显著更高。然而,尿液中VEGF水平与VEGF基因型无显著关系。尿液VEGF水平与尿白蛋白排泄、蛋白尿、血清肌酐水平和肌酐清除率以及空腹血糖水平、餐后2小时血糖水平和C反应蛋白显著相关。
我们的研究表明,VEGF基因的936 C/T多态性可能是决定血浆VEGF水平的重要因素,其多态性与糖尿病视网膜病变相关。尿液中VEGF水平与血浆VEGF水平无关,与糖尿病肾病的分期相关。