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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Background Vascular end othelial growth factor (VEGF) is a heparin-binding homodimeric glycoprotein. It plays a key role in the pathogenesis of diabetes mellitus (DM) and its complications, particularly those linked with poor vascularization and hypoxia. The VEGFA gene encodes VEGF, and several genetic variants have been identified in the VEGFA gene, some of which affect VEGF secretions. Objectives To investigate the association between serum levels of VEGF and VEGFA gene variants, −583C>T(rs3025020) and +936 C/T (rs3025039), with microvascular complications in type 2 diabetics. Patients and methods This cross-sectional study was conducted on 104 patients with type 2 DM who were classified into four groups (each comprised 26 patients): diabetic nephropathy, neuropathy, and retinopathy groups, and an uncomplicated DM group as a case–control group. Clinical, neurological, and fundus examinations, as well as biochemical laboratory investigations were done for all patients. The serum VEGF assay was done by ELISA. VEGFA genotyping was performed by allelic discrimination using a real-time PCR system. Results VEGF was significantly reduced in diabetic nephropathy group than in uncomplicated DM group, especially those with C/C and C/T of rs3025020 (P = 0.04 and P = 0.02, respectively) and the C/T genotype of rs3025039 (P = 0.01). There was a significant difference in distribution of rs3025039 and its both alleles (C and T) in diabetic nephropathy (P = 0.001) compared with other studied groups. The C/T genotype of rs3025039 and its T allele had a significant high frequency in diabetic nephropathy (odds ratio = 4.2 and 6.9, respectively) than in uncomplicated DM. Conclusion A reduction in VEGF level occurred in diabetic nephropathy than in uncomplicated DM, especially those with C/T genotypes of studied variants. C/T genotype and its T allele of rs3025039 had a higher frequency in diabetic nephropathy, so it was considered a risk gene for only diabetic nephropathy.

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