Elevated plasma vascular endothelial cell growth factor and thrombomodulin in juvenile diabetic patients

Area of Science:

• Endocrinology
• Diabetology
• Vascular Biology

Background:

• Type 1 diabetes mellitus (T1DM) is a leading cause of morbidity and mortality, primarily due to vascular complications.
• Elevated blood glucose in T1DM patients damages endothelial cells, increasing markers like von Willebrand factor (vWF) and thrombomodulin (TM).
• Vascular endothelial growth factor (VEGF) is implicated in smooth muscle cell proliferation and vascular occlusion, with elevated levels observed in diabetic retinopathy.

Purpose of the Study:

• To investigate plasma levels of TM and VEGF in juvenile T1DM patients without clinical signs of vascular disease.
• To determine if early markers of endothelial damage and vascular growth factors are elevated in children with T1DM.

Main Methods:

• Plasma TM and VEGF levels were measured in juvenile T1DM patients and age/sex-matched healthy controls.
• The Mann-Whitney U test was used for statistical analysis of TM and VEGF levels.
• Patients were assessed for clinical evidence of vascular disease.

Main Results:

• Median TM levels were significantly higher in T1DM patients (61 ng/mL) compared to controls (45.5 ng/mL) (p = .0005).
• Median VEGF levels were also significantly elevated in T1DM patients (37.1 pg/mL) versus controls (19.6 pg/mL) (p = .027).
• These elevations were observed in T1DM patients with no clinical evidence of vascular disease.

Conclusions:

• Microvascular disease in T1DM may initiate in childhood.
• Plasma TM and VEGF levels serve as potential early biomarkers for detecting subclinical vascular damage in pediatric T1DM.
• Early detection through laboratory testing can precede clinical manifestation of vascular complications.