The Levels Of Plasma HIF-1αand VEGF In Patients With T2DM And The Correlation With Diabetic Peripheral Neuropathy

Objective:To investigate the levels of hypoxia inducible factor-1α(HIF-1α) andvascular endothelial growth factor (VEGF) in patients with Type 2 diabeticmellitus (T2DM) and their correlations with diabetic peripheral neuropathy(DPN). To analyze the risk factors for DPN.Methods:Forty-four patients with T2DM and nineteen healthy volunteers wereincluded in this study, the enzyme-linked immune-sorbent assay (ELISA) wasused to detect the plasma HIF-1αand VEGF levels in all the subjects. Theclinical data including age, sex, diabetic duration, systolic pressure, diastolicpressure, body mass index (BMI) , cholesterol (TC), triglyceride (TG),creatinine (Cr), blood urea nitrogen (BUN), glycosylated hemoglobin (HbA1c),hemoglobin et al were assayed to investigate their relationships with plasmaHIF-1αand VEGF respectively. All the T2DM were given routinehypoglycemic therapy and the changes of plasma HIF-1α, VEGF levels wereobserved thereafter. According to the Michigan neuropathy screeninginstrument (MNSI), the T2DM in our study were divided into group DPN (23cases) and group N-DPN (21 cases), the levels of plasma HIF-1αand VEGFwere then analyzed between two groups and the risk factors for DPN werediscussed.Results:1. The patients with T2DM had significantly higher HIF-1αand VEGF levels(752.4±368.0pg/ml, 49.3±45.9pg/ml) than that of normal controlgroup(594.0±177.9pg/ml, 27.0±14.1pg/ml), and the levels of HbA1c, VLDL,Cr, BUN, ApoA1, ALB, A/G, hemoglobin were statistically different betweentwo groups (P＜0.05). In Linear regression analysis, plasma HIF-1αlevelwas significant associated with A/G, and HbA1cwas the independentinfluence factor with VEGF. Plasma HIF-1αwas positively related withVEGF(r=0.315，P=0.037).2. After about 8.8±4.0 days of hypoglycemic therapy, the daily bloodglucose was decreased significantly (14.5±4.1mmol/l vs 8.5±2.1mmol/l), butthere was no evident changes for plasma HIF-1αas well as VEGF (both P＞0.05).3. There was no statistical difference between the group DPN and thegroup N-DPN when taking the plasma HIF-1αand VEGF into comparison(P＞0.05).4. The hemoglobin, BMI and MCV in group DPN (131.0±22.6g/l，23.7±3.4kg/m2，94.0±4.3/fl) were significantly lower than those of in groupN-DPN (112.8±20.1g/l，21.9±2.1kg/m2，89.1±8.2/fl) with P＜0.05 . Thegroup DPN had longer disease duration and higher levels of BUN (P＜0.05).Logistic regression analysis showed that disease duration and anemia were therisk factors for DPN (P < 0.01).Conclusion:1. The plasma HIF-1αand VEGF might be the makers of diabetic stress damage.2. The levels of HIF-1αand VEGF may be influenced by hypoxia orother factors in T2DM and short time hypoglycemic therapy had little effecton HIF-1αand VEGF.3. Diabetic duration and anemia might be the risk factors for DPN.Besides blood glucose management, we should also pay attention to thecombined anemia for better prevent DPN in T2DM.