Albuminuria and VEGF as early markers of cardiovascular disturbances in young type 1 diabetic patients.
OBJECTIVE
The aim of the study was to assess myocardial perfusion by means of non-invasive diagnostic methods and measurement of the plasma concentration of vascular endothelial growth factor (VEGF) in patients with long-lasting type 1 diabetes.


RESULTS
The study was performed on 41 Type 1 diabetic patients (23 females, 18 males), aged 30±7.6 with a duration of disease 15.2±5.5years. 17 patients exhibited microalbuminuria (10 females, 7 males) and 24 subjects were without microalbuminuria (13 females, 11 males). The methods used included a 24-h ECG tape, an exercise treadmill test, echocardiological evaluation with dobutamine and atropine challenge and single photon emission computer tomography (SPECT) at rest, and after dipyridamol induction of ischemia. All the exercise and stress echocardiography tests were negative. There were significant differences between microalbuminuric and normoalbuminuric subjects in the duration of their exercise tests (586.9±110.5 vs. 664.9±133.2s, p=0.027), performed work (11.4±1.6.vs. 12.6±1.8 METs, p=0.045), achieved pulse limit (89.1±3.6 vs. 92.6±5.2%, p=0.037), rest ejection fraction (55.8±8.7 vs. 62.0±4.4%, p=0.040), abnormal changes in SPECT (53 vs. 21%, p=0.047) and VEGF concentration (101.5±7.8 vs. 75.15±16.5pg/ml, p<0.05). The presence of retinopathy increased 12-fold the probability of significant changes in the SPECT (OR 12.1, 95% CI 1.38-105.64, p=0.02) and nephropathy (OR 4.27; 95%CI 1.09-16.83, p=0.03).


CONCLUSIONS
Asymptomatic patients with long lasting type 1 diabetes may have disturbances in myocardial perfusion, especially these with microalbuminuria.
Naskret
Dariusz
D
Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland. mdmn@poczta.wp.pl
Zozulinska-Ziolkiewicz
Dorota A
DA
Dankowski
Rafal
R
Wysocki
Henryk
H
Wierusz-Wysocka
Bogna
B
D000328:Adult; D000367:Age Factors; D000419:Albuminuria / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055414:Myocardial Perfusion Imaging; D016017:Odds Ratio; D011044:Poland; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A