Low plasma basic fibroblast growth factor is associated with laser photocoagulation treatment in adult type 2 diabetes mellitus from the Veterans Affairs Diabetes Trial.
Basic fibroblast growth factor (bFGF) is a potent endothelial cell mitogen that does not normally circulate. Yet plasma bFGF-like bioactivity was increased in association with persistent microalbuminuria and retinopathy in adult type 2 diabetes mellitus. In the present study, we tested whether plasma bFGF immunoreactivity (IR) could predict the need for laser treatment of diabetic retinopathy in a baseline subset of advanced type 2 diabetes mellitus from the Veterans Affairs Diabetes Trial (mean: age, 59 years; diabetes duration, 11 years; baseline glycosylated hemoglobin, 9.5%). Plasma bFGF-IR was determined with a sensitive and specific 2-site enzyme-linked immunoassay in 172 patients at the baseline visit. Results were dichotomized at 4.5 pg/mL, the upper limit in healthy men. There was an unexpected significant association between low baseline plasma bFGF-IR level and the interim (4 years) need for laser treatment. First laser treatment was significantly more likely to be required in patients with low compared with high baseline bFGF (19% vs 6%, P = .03 for the difference). After adjusting for clinical risk factors, low vs high bFGF (hazard ratio [HR], 5.01; P = .012), duration of diabetes (HR, 1.05; P = .050), and low-density lipoprotein cholesterol concentration (HR, 0.98; P = .027) were all significantly associated with time to first laser occurrence. These and our prior results suggest that low plasma bFGF-IR may be a marker for the presence of anti-endothelial cell autoantibodies that may contribute to the need for laser photocoagulation treatment in adult men with advanced type 2 diabetes mellitus.
Zimering
Mark B
MB
Medical Service, Department of Veterans Affairs New Jersey Health Care System, Lyons, NJ 07939, USA. mark.zimering@med.va.gov
Anderson
Robert J
RJ
Moritz
Thomas E
TE
Ge
Ling
L
D000328:Adult; D000368:Aged; D000818:Animals; D001323:Autoantibodies / Q000097:blood; D001794:Blood Pressure; D002417:Cattle; D002452:Cell Count; D002846:Chromatography, Affinity; D003124:Colorimetry; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003930:Diabetic Retinopathy / Q000601:surgery*; D004730:Endothelium, Vascular / Q000166:cytology / Q000276:immunology; D016222:Fibroblast Growth Factor 2 / Q000097:blood*; D006801:Humans; D017075:Laser Coagulation; D008875:Middle Aged; D011651:Pulmonary Artery; D013205:Staphylococcal Protein A / Q000302:isolation & purification
D001323:Autoantibodies; D013205:Staphylococcal Protein A; D016222:Fibroblast Growth Factor 2