April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Relationship between vascular endothelial growth factor (VEGFA), biomarkers of inflammation and dysglycemia
Author Affiliations & Notes
  • Katrin Engelmann
    Ophthalmology, Klinikum Chemnitz gGmbH, Chemnitz, Germany
    CRTD Center for Regenerative Therapies Dresden - DFG Cluster of Excellence, Dresden, Germany
  • Dieter Appelt
    Endocrinology and Metabolic Disorders, GWT-TUD GmbH, Dresden, Germany
  • Frank Pistrosch
    Endocrinology and Metabolic Disorders, GWT-TUD GmbH, Dresden, Germany
  • Dirk Sandner
    Klinik für Augenheilkunde, Universitätsklinikum Carl-Gustav Carus, Dresden, Germany
  • Elena Henkel
    Endocrinology and Metabolic Disorders, GWT-TUD GmbH, Dresden, Germany
  • Carsta Koehler
    Medical Consulting, GWT-TUD GmbH, Dresden, Germany
  • M. Hanefeld
    Endocrinology and Metabolic Disorders, GWT-TUD GmbH, Dresden, Germany
  • Footnotes
    Commercial Relationships Katrin Engelmann, None; Dieter Appelt, None; Frank Pistrosch, None; Dirk Sandner, None; Elena Henkel, None; Carsta Koehler, None; M. Hanefeld, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2243. doi:
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      Katrin Engelmann, Dieter Appelt, Frank Pistrosch, Dirk Sandner, Elena Henkel, Carsta Koehler, M. Hanefeld; Relationship between vascular endothelial growth factor (VEGFA), biomarkers of inflammation and dysglycemia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2243.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Abnormal VEGF plays a pivotal role in the pathogenesis of diabetic maculopathy and retinopathy. Vice versa low systemic VEGF levels seem to be associated with impaired angiogenesis in patients with type 2 diabetes and cardiovascular disease. Recently long lasting decrease in systemic VEGF levels was reported after intraocular anti-VEGF treatment of diabetic macular edema. So far little is known on relationship between VEGF, activation of the inflammation cascade and other cardiovascular risk factors in different categories of glucose intolerance. This proatherogenic cascade may be a link between systemic effects of intraocular anti-VEGF therapy and vascular complications. In addition to previous studies with prediabetes we therefore analysed the relationship between VEGF-A, biomarkers of inflammation (BI), other cardiovascular risk factors (RF) and HbA1c in advanced type 2 diabetes.

 
Methods
 

251 subjects matched for BMI and age: 50 with normal glucose tolerance (NGT), 50 with pre-diabetes (PRE-DM), 100 with early diabetes (E-DM) and 51 with advanced A-DM were analysed for VEGF-A, BI and HbA1c. Statistics: t-test with CI, Anova, univariate correlation and stepwise regression analysis with VEGF-A as dependent variable.

 
Results
 

Patients were well matched for age, BMI and sex. As shown in tab. A-DM shows a significant increase in hsCRP and VEGF-A. In univariate analysis we found a significant correlation of VEGF-A with hsCRP and HbA1c in the overall population. However, VEGF-A was inversely correlated to age. In A-DM age (R=-0,37) and hsCRP (R= 0,36) were significantly correlated to VEGF-A. In multivariate analysis only the parameter hsCRP and adiponectin have an independent association to VEGF-A.

 
Conclusions
 

Our analysis reveals a robust correlation between VEGF-A and hsCRP in the overall population and in addition for HbA1c and VEGF-A in patients with poorly controlled diabetes. A DM represents a Bermuda triangle of high HbA1c, elevated VEGF-A and activated inflammation. These data suggest that hsCRP as gold standard of low grade inflammation may be used as risk marker also for follow-up of anti-VEGF-A therapy. Prospective studies are needed to validate cardiovascular risk associated with systemic effects of anti-VEGF-therapy.

  
Keywords: 498 diabetes • 499 diabetic retinopathy • 748 vascular endothelial growth factor  
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