2型糖尿病对周围动脉疾病患者血浆血管内皮生长因子及其可溶性受体1型和2型水平的影响。
Impact of type 2 diabetes on the plasma levels of vascular endothelial growth factor and its soluble receptors type 1 and type 2 in patients with peripheral arterial disease.
作者信息
Wieczór Radosław, Gadomska Grażyna, Ruszkowska-Ciastek Barbara, Stankowska Katarzyna, Budzyński Jacek, Fabisiak Jacek, Suppan Karol, Pulkowski Grzegorz, Rość Danuta
机构信息
Department of Pathophysiology, Faculty of Pharmacy, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz PL 85-094, Poland.
Clinic of Vascular and Internal Medicine, Dr. Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz PL 85-168, Poland.
出版信息
J Zhejiang Univ Sci B. 2015 Nov;16(11):948-56. doi: 10.1631/jzus.B1500076.
OBJECTIVE
Type 2 diabetes coexistent with lower extremity artery disease (peripheral arterial disease (PAD)) can be observed in numerous patients. The mechanism compensating for ischemia and contributing to healing is angiogenesis-the process of forming new blood vessels. The purpose of this study was to assess the likely impact of type 2 diabetes on the plasma levels of proangiogenic factor (vascular endothelial growth factor A (VEGF-A)) and angiogenesis inhibitors (soluble VEGF receptors type 1 and type 2 (sVEGFR-1 and sVEGFR-2)) in patients with PAD.
METHODS
Among 46 patients with PAD under pharmacological therapy (non-invasive), we identified, based on medical history, a subgroup with coexistent type 2 diabetes (PAD-DM2+, n=15) and without diabetes (PAD-DM2-, n=31). The control group consisted of 30 healthy subjects. Plasma levels of VEGF-A, sVEGFR-1, and sVEGFR-2 were measured using the enzyme-linked immunosorbent assay (ELISA) method.
RESULTS
The subgroups of PAD-DM2+ and PAD-DM2- revealed significantly higher concentrations of VEGF-A (P=0.000 007 and P=0.000 000 1, respectively) and significantly lower sVEGFR-2 levels (P=0.02 and P=0.000 01, respectively), when compared with the control group. Patients with PAD and coexistent diabetes tended to have a lower level of VEGF-A and higher levels of sVEGFR-1 and sVEGFR-2 comparable with non-diabetic patients.
CONCLUSIONS
The coexistence of type 2 diabetes and PAD is demonstrated by a tendency to a lower plasma level of proangiogenic factor (VEGF-A) and higher levels of angiogenesis inhibitors (sVEGFR-1 and sVEGFR-2) at the same time. Regardless of the coexistence of type 2 diabetes, hypoxia appears to be a crucial factor stimulating the processes of angiogenesis in PAD patients comparable with healthy individuals, whereas hyperglycemia may have a negative impact on angiogenesis in lower limbs.
目的
众多患者中可观察到2型糖尿病与下肢动脉疾病（外周动脉疾病（PAD））并存。补偿缺血并促进愈合的机制是血管生成——形成新血管的过程。本研究的目的是评估2型糖尿病对PAD患者促血管生成因子（血管内皮生长因子A（VEGF - A））和血管生成抑制剂（可溶性血管内皮生长因子受体1型和2型（sVEGFR - 1和sVEGFR - 2））血浆水平的可能影响。
方法
在46例接受药物治疗（非侵入性）的PAD患者中，根据病史，我们确定了一个并存2型糖尿病的亚组（PAD - DM2 +，n = 15）和无糖尿病的亚组（PAD - DM2 -，n = 31）。对照组由30名健康受试者组成。使用酶联免疫吸附测定（ELISA）方法测量VEGF - A、sVEGFR - 1和sVEGFR - 2的血浆水平。
结果
与对照组相比，PAD - DM2 +和PAD - DM2 -亚组的VEGF - A浓度显著更高（分别为P = 0.000007和P = 0.0000001），sVEGFR - 2水平显著更低（分别为P = 0.02和P = 0.00001）。与非糖尿病患者相比，患有PAD且并存糖尿病的患者VEGF - A水平往往更低，sVEGFR - 1和sVEGFR - 2水平更高。
结论
2型糖尿病与PAD并存表现为促血管生成因子（VEGF - A）血浆水平降低和血管生成抑制剂（sVEGFR - 1和sVEGFR - 2）水平升高的趋势。无论2型糖尿病是否并存，与健康个体相比，低氧似乎是刺激PAD患者血管生成过程的关键因素，而高血糖可能对下肢血管生成产生负面影响。
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