Endothelial nitric oxide synthase (eNOS) is not upregulated in gastric mucosa of Helicobacter pylori (H. pylori)-positive patients with type 2 diabetes mellitus.
OBJECTIVE
To evaluate the expression of eNOS and CD34 in gastric mucosa of Helicobacter pylori (H. pylori) positive diabetic patients, in correlation with glycaemic control and diabetic autonomic neuropathy (DAN).


METHODS
We prospectively studied 49 diabetic type 2 patients (29 women, mean age 65.32+/-8.56 years) and 30 control subjects (15 women, mean age 58.47+/-12.40) that underwent endoscopy. Biopsies from the body and antrum were evaluated for H. pylori-gastritis, eNOS and angiogenic marker CD34 expression. Statistical analysis in correlation with mean glycosylated haemoglobin (HbA1c) of the last 3 years, and DAN was performed.


RESULTS
The two groups were matched for age (p=0.144), sex (p=0.335), H. pylori-infection (p=0.617) and degree of gastritis (p=0.78). eNOS and CD34 attenuated expression correlated with diabetes mellitus (DM) in the corpus (p=0.009 and 0.02, respectively). eNOS and CD34 expression was upregulated in H. pylori-positive controls but not in H. pylori-positive diabetic patients (p=0.010 and 0.007 for the corpus and p=0.036 and 0.047 for the antrum, respectively). eNOS expression correlated with good glycaemic control (GGC) in the gastric corpus (p<0.001) and antrum (p=0.0037) and with absence of DAN (p=0.009 and 0.036, respectively for the corpus and antrum).


CONCLUSIONS
Chronic glycaemic control affects eNOS expression and angiogenesis in the gastric mucosa of patients with type 2 DM. eNOS expression is not upregulated in H. pylori-positive diabetic patients.
Lazaraki
G
G
First Department of Internal Medicine, Gastroenterology Clinic, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. lazarakg@yahoo.com
Kountouras
J
J
Metallidis
S
S
Vrettou
E
E
Alevizos
M
M
Tzioufa
V
V
Dokas
S
S
Germanidis
G
G
Zavos
C
C
Nikolaidis
P
P
D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000201:enzymology* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004727:Endothelium / Q000098:blood supply / Q000201:enzymology / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply / Q000201:enzymology* / Q000473:pathology; D005756:Gastritis / Q000201:enzymology* / Q000473:pathology; D006442:Glycated Hemoglobin / Q000378:metabolism; D016481:Helicobacter Infections / Q000201:enzymology* / Q000473:pathology; D016480:Helicobacter pylori / Q000378:metabolism*; D006801:Humans; D008297:Male; D055806:Microvessels / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism*; D011446:Prospective Studies; D015854:Up-Regulation
D018952:Antigens, CD34; D015415:Biomarkers; D006442:Glycated Hemoglobin; D052250:Nitric Oxide Synthase Type III