ASSOCIATION OF CIRCULATING SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR-A WITH

VASCULAR ULTRASOUND DETERMINANTS OF DEMENTIA IN PATIENTS WITH TYPE 2 DIABETIC NEPHROPATHY

Grigorios G. Dimas1, Thomas J. Tegos2, Galaktion N. Konstantinidis1, Fotios S. Iliadis1, Ilias E. Kanellos1, Sofia G. Spiroglou3, Spiros D. Fotiadis1, Ioannis M. Karamouzis1, Christos G Savopoulos1, Apostolos I. Hatzitolios1, Dimitrios M. Grekas1.

 1 1st Propaedeutic Medical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece2 1st Neurology Medical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece3 Biochemistry Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece

Background

• It remains controversial the mechanism by which vascular endothelial growth factor

(VEGF) works in the kidney, as well as in the vessels at least in the early stages of

diabetic nephropathy (DN) and chronic kidney disease (CKD). VEGF-A may play a role in

the pathophysiology of Vascular Dementia (VD).

• VEGF-A is elevated in postmortem brain tissue of VD patients. 

Aim

• The aim of the present study was to determine the serum levels of VEGF-A and to

investigate their potential correlation with the atherosclerotic markers and albuminuria and

VD in hypertensive patients with early stages of type 2 DN.

Methods

• CKD patients of stages 1 and 2 with type II DN (n=40) were included.

• As controls, there were healthy individuals (n=40). VEGF-A levels were measured by an

ELISA method. Intima media thickness of carotid and femoral arteries and atheromatic

plaque were evaluated by a high resolution ultrasonography.

• Each artery was assigned a score (atherosclerotic ultrasonic score – ATHUS).

• Subsequently, the mini-mental score examination (MMSE) of every patient was

evaluated.

Results

• There was a notable difference between VEGF-A levels in each of the groups.

• There was a statistically significant correlation between levels of VEGF-A and

albuminuria (p<0.0001).

• Further, VEGF-A levels were independently correlated with IMT and atheromatic

plaque (p<0.0001) and MMSE score in DN patients.

Conclusion

• Our study suggests that serum levels of VEGF-A might present independent risk

factors of atherosclerosis, albuminuria and vascular dementia in patients with early

stages of type II DN to the progression of CKD.