J.ophthalmol.(Ukraine).2018;2:11-16.
https://doi.org/10.31288/oftalmolzh/2018/2/1116
Relationships of vascular endothelial growth factor (VEGFA) with stage of diabetic retinopathy and disease duration in patients with type 2 diabetes mellitus
A. S. Hudz1, Dr Sc (Med), G. Ie. Zakharevych, Assistant, O. V. Pentrenko2, Dr Sc (Med), S. V. Ziablitsev3, Dr Sc (Med), Prof., V. S. Dzhordzhua4, Ophthalmologist
1 Ophthalmology Department, Danylo Halytsky Lviv National Medical University; Lviv (Ukraine)
2 Ophthalmology Department, Shupik National Medical Academy of Postgraduate Education; Kyiv (Ukraine)
3 Bohomolets National Medical University; Kyiv (Ukraine)
4 Hospital Garcia de Orta EPE; Almada (Portugal)
E-mail: anhudz@gmail.com
TO CITE THIS ARTICLE: Hudz AS, Zakharevych GIe, Pentrenko OV, Ziablitsev SV, Dzhordzhua VS. Relationships of vascular endothelial growth factor (VEGFA) with stage of diabetic retinopathy and disease duration in patients with type 2 diabetes mellitus. J.ophthalmol.(Ukraine).2018;2:11-6. https://doi.org/10.31288/oftalmolzh/2018/2/1116
Background: As there is currently an epidemic of type 2 diabetes mellitus (T2DM), increasing attention should be paid to diabetic retinopathy (DR), a major complication of the disease which can lead to disability and blindness. Increased levels of growth factors (mainly, vascular endothelial growth factor (VEGFA)), angiogenesis factors, and cytokines in the aqueous humor have been reported in DR.
Purpose: To identify the relationship of VEGFA with the stage of DR and duration of disease in T2DM through (1) investigation of the effect of increased aqueous VEGFA level on DR complications and (2) estimation of the sensitivity of clinical and laboratory indicators to the amount of VEGFA in the aqueous humor.
Materials and Methods: Totally, 302 persons (604 eyes) were included in the study. Patients with T2DM were divided into three groups according to the severity of DR: Group 1 (no retinopathy, 76 patients), Group 2 (non-proliferative DR, 64 patients), and Group 3 (proliferative DR, 64 patients). The control group included 98 individuals with no T2DM or DR. Aqueous humor VEGFA levels were measured using enzyme-linked immunosorbent assay kits from eBioscience. Statistical analyses were performed using SPSS 11.0, MedCalc v.15.11.0 and Medstat Software.
Results: Regression analyses demonstrated that aqueous VEGFA level directly and significantly influences the stage of DR and diabetes duration at baseline (P = 2.27E-08 and P =6.15E-05, respectively). In addition, increased aqueous VEGFA levels significantly influence the probability of developing neovascularization in the ocular tissue, vitreous hemorrhage or PDR (P < 0.05). An increase in the probability of developing optic disc neovascularization, retinal neovascularization, vitreous hemorrhage, vitreoretinal neovascularization, or PDR occurs with an increase in aqueous VEGFA level above 992 pg/mL, 923 pg/mL, 1005 pg/mL, 1022 pg/mL; and 926 pg/mL, respectively.
Conclusion: Elevated aqueous VEGFA levels are a potent pathogenic factor for progression of DR in patients with T2DM.
Key-words: diabetic retinopathy, vascular endothelial growth factor (VEGFA)
References
- Vlasenko MV. [Diabetes mellitus: diagnosing and monitoring]. Liky Ukrainy. 2013;(9-10):17-18. Ukrainian
- Pan’kiv VI. [Workshop No. 162. Diabetes mellitus: Diagnostic criteria, etiology and pathogenesis]. Mizhnarodnyi endokrynologichnyi zhurnal. 2013;8:53-64 Ukrainian
- Wu CM, Wu AM, Young BK, et al. An appraisal of clinical practice guidelines for diabetic retinopathy. Am J Med Qual. 2016 Jul;31(4):370-5
Crossref Pubmed - Scanlon PH, Aldington SJ, Stratton IM. Epidemiological issues in diabetic retinopathy. Middle East Afr J Ophthalmol. 2013 Oct-Dec;20(4):293-300
Crossref Pubmed - Sayin N, Kara N, Pekel G. Ocular complications of diabetes mellitus. World J Diabetes. 2015; 6(1):92–10
Crossref Pubmed - Chun MY, Hwang HS, Cho HY, et al. Association of vascular endothelial growth factor polymorphisms with nonproliferative and proliferative diabetic retinopathy. J Clin Endocrinol Metab. 2010 Jul;95(7):3547-51
Crossref Pubmed - Agarwal A, Soliman MK, Sepah YJ, et al. Diabetic retinopathy: variations in patient therapeutic outcomes and pharmacogenomics. Pharmgenomics Pers Med. 2014 Dec 12;7:399-409
- Izuta H, Matsunaga N, Shimazawa M, et al. Proliferative diabetic retinopathy and relations among antioxidant activity, oxidative stress, and VEGF in the vitreous body. Mol Vis. 2010;16:130–6
- Konenkov VI, Klimontov VV, Chernykh VV, Tjan NV. [Angiogenesis in proliferative diabetic retinopathy: prospects of anti-VEGF therapy]. Fyodorov Journal of Ophthalmic Surgery. 2013;(4):111-115. Russian
- Abouammoh MA. Ranibizumab injection for diabetic macular edema: meta-analysis of systemic safety and systematic review. Can J Ophthalmol. 2013 Aug;48(4):317-23
Crossref Pubmed - Bonnefond A, Saulnier PJ, Stathopoulou MG, et al. What is the contribution of two genetic variants regulating VEGF levels to type 2 diabetes risk and to microvascular complications? PLoS One. 2013;8(2):e55921
Crossref Pubmed - Han L, Zhang L, Xing W, et al. The associations between VEGF gene polymorphisms and diabetic retinopathy susceptibility: a meta-analysis of 11 case-control studies. J Diabetes Res. 2014; 2014: 805801
Crossref Pubmed