title: Circulating angiogenic factors in diabetes patients in a tertiary hospital in Ghana.
abstract: BACKGROUND
  Impaired angiogenesis is amongst the underlining mechanisms of organ damage in diabetes and hypertensive patients. In diabetes and hypertensive patients without proteinuria and overt CVDs, we studied the levels of angiogenic growth factors, angiopoietin (Ang)-1, Ang-2 and vascular endothelial growth factor (VEGF), and the relationship between these angiogenic growth factors and renal function, measured as estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  In a case control design, 107 type 2 diabetes (T2DM) patients and 93 non-diabetes controls were recruited into the study. Levels of plasma glucose, lipids, creatinine and angiogenic growth factors; Ang-1, Ang-2 and VEGF measured from fasting blood samples. Estimated glomerular filtration rate (eGFR) was computed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) algorithm and eGFR < 60 ml/min/1.73 m2was considered to be low. Multivariable logistic regression was used to assess the odds of change in angiogenic growth factors among patients with diabetes and hypertension, and patients with low eGFR, compared to those without these conditions.
  
  
  RESULTS
  In a total of 200 participants with 49 % females and mean age of 54.1 ± 10.2 years, 22.7 % of T2DM patients and 13.3 % of non-diabetes participant had low eGFR. The levels of Ang-1 and Ang-2 were highest in hypertensive T2DM patients, followed by patients with either T2DM or hypertension alone, with the controls having the lowest levels. The odds of change in circulating Ang-2 levels increased in patients with both diabetes and hypertension [11.76 (7.97-16.63),p< 0.01] compared to patients with either diabetes [5.45 (3.31-9.71),p= 0.02] or hypertension [5.45 (3.31-9.71),p= 0.02] alone. Compared to those with normal eGFR, the odds of change in serum Ang-2 levels were increased in patients with low eGFR in both the crude [1.26 (1.08-2.110),p= 0.023] and adjusted [1.14 (1.03-2.34),p= 0.043] regression models.
  
  
  CONCLUSIONS
  In our study population, having diabetes and hypertension increased the levels of Ang-1 and Ang-2. Also, low eGFR status was associated with increased levels of Ang-2 after adjustment for other risk factors.
authors: Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P O Box KB143, Korle-Bu, Accra, Ghana.
authors: Kwame
authors: 0000-0001-5240-0645
authors: K
authors: Yeboah
authors: Department of Immunology, Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana.
authors: Eric
authors: E
authors: Kyei-Baafour
authors: Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P O Box KB143, Korle-Bu, Accra, Ghana.
authors: Daniel A
authors: DA
authors: Antwi
authors: Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
authors: Henry
authors: H
authors: Asare-Anane
authors: Department of Immunology, Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana.
authors: Ben
authors: B
authors: Gyan
authors: Department of Medicine & Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana ; National Diabetes Management & Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana.
authors: Albert G B
authors: AG
authors: Amoah
keywords: Angiopoietins; Diabetes; Estimated glomerular filtration rate; Ghana; Hypertension