Serum vascular endothelial growth factor and diabetic nephropathy progression

To determine the serum levels of vascular endothelial growth factor (VEGF) at different stages of diabetic nephropathy. Study subjects were divided into three groups: subjects in group 1 were microalbuminuric diabetic (n = 33), in group 2 subjects were normoalbuminuric diabetic group (n = 32), and group 3 was formed from nondiabetic healthy control subjects (n = 18). VEGF, microalbuminuria, HbA1c, creatinine, triglycerides, total cholesterol, fasting serum glucose, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. Serum VEGF concentrations were significantly higher in the diabetic groups than in the control group even at the normoalbuminuric stage. Serum VEGF levels were higher in the microalbuminuria group than in the normoalbuminuria group. Serum VEGF levels increased with diabetic nephropathy stage. In the diabetic group, serum VEGF appeared to be positively correlated with fasting plasma glucose, HbA1c, LDL, creatinin and microalbuminuria. Serum VEGF was found to be negatively correlated with serum HDL. We have shown that serum levels of VEGF represents an early marker of generalized vascular dysfunction, and this peptide contributes to endothelial damage in diabetes. Elevated serum VEGF levels in the normoalbuminuric stage could indicate that generalized vascular dysfunction is present even at this stage.