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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Correlation between carotid artery distensibility and serum vascular endothelial growth factor concentrations in type
J Valabhji1, S Dhanjil, A N Nicolaides
1Section of Endocrinology and Metabolic Medicine and the Irvine Laboratory, Imperial College School of Medicine, St Mary's Hospital, London, UK.
Insights
Serum vascular endothelial growth factor (VEGF) is inversely related to vessel wall distensibility in type 1 diabetes. Lower distensibility in diabetics may be linked to higher VEGF levels, impacting vascular health.
Area of Science:
- Cardiovascular Science
- Endocrinology
- Medical Imaging
Background:
- Vascular endothelial growth factor (VEGF) plays a role in vascular health.
- Type 1 diabetes is associated with cardiovascular complications.
- Understanding the relationship between VEGF and vessel wall mechanics is crucial.
Purpose of the Study:
- To investigate the association between serum VEGF concentrations and carotid artery wall distensibility in type 1 diabetic and nondiabetic individuals.
- To determine if VEGF levels correlate with measures of arterial stiffness.
Main Methods:
- Serum VEGF levels were measured in 41 type 1 diabetic and 50 nondiabetic subjects.
- Carotid artery distensibility was assessed using M-mode ultrasound, calculating the distensibility index.
- Pulse pressure and hemoglobin A1c were also recorded.
Main Results:
- Serum VEGF concentrations were significantly higher in type 1 diabetic subjects.
- Despite similar carotid artery luminal diameter changes, diabetic subjects had higher pulse pressure and a lower distensibility index.
- Serum VEGF showed a strong inverse correlation with carotid artery distensibility in both diabetic and nondiabetic groups.
Conclusions:
- Vessel wall distensibility is a significant determinant of serum VEGF concentrations in both diabetic and nondiabetic populations.
- The findings suggest a potential link between VEGF, arterial stiffness, and cardiovascular risk in type 1 diabetes.
- Further research is needed to elucidate the pathophysiologic relevance of these associations.
Abstract:
The relationships between serum vascular endothelial growth factor (VEGF) concentrations and vessel wall ultrasonic characteristics in type 1 diabetic and nondiabetic subjects were assessed. Serum VEGF concentration was measured, and ultrasound imaging and blood pressure recordings were performed in 41 type 1 diabetic subjects (hemoglobin A(1c) [HbA(1c)], 7.63 [1.17%]; duration of diabetes, 12 (0 to 23) years), and 50 nondiabetic subjects. Change in carotid artery luminal diameter during the cardiac cycle was measured using M-mode ultrasound, from which percentage increase in carotid artery luminal diameter was calculated; the carotid artery distensibility index was calculated as the ratio of percentage increase in carotid artery luminal diameter and pulse pressure. Serum VEGF concentration was higher in the diabetic subjects (217 [135 to 336] v 137 [80 to 237] pg/mL; P =.009). The percentage increase in carotid luminal diameter during the cardiac cycle was not significantly different between the 2 groups (12.9 [10.2 to 15.7] v 13.0 [10.6 to 15.0%]; P =.270) despite significantly greater pulse pressure in the type 1 diabetic group (55 [45 to 71] v 46 [41 to 51] mm Hg; P =.0003). The distensibility index was therefore lower in the diabetic subjects (0.24 [0.10] v 0.28 [0.08%]/mm Hg; P =.031). There was a significant negative correlation between serum VEGF concentrations and mean percentage increase in carotid luminal diameter during the cardiac cycle in the diabetic group (r = -.36, P =.021) and in the nondiabetic group (r = -.28, P =.047). This negative correlation could be strengthened by relating mean percentage increase in luminal diameter to pulse pressure to give the distensibility index. Therefore, serum VEGF concentrations correlated strongly and inversely with the distensibility index in the diabetic group (r = -.49, P =.001), in the nondiabetic group (r = -.29, P =.041), and in both groups analyzed together (r = -.42, P <.0001). Vessel wall distensibility may be an important determinant of serum VEGF concentrations in both diabetic and nondiabetic populations and may underlie the previously observed association between blood pressure and serum VEGF concentrations. The pathophysiologic relevance of these findings remains to be elucidated.
