This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Santilli, F. Articles by Chiarelli, F. Search for Related Content PubMed PubMed Citation Articles by Santilli, F. Articles by Chiarelli, F.

Increased Vascular Endothelial Growth Factor Serum Concentrations May Help to Identify Patients with Onset of Type 1 Diabetes during Childhood at Risk for Developing Persistent Microalbuminuria

Department of Medicine, Division of Pediatrics, University of Chieti, 66100 Chieti, Italy; and Department of Pediatrics, Oregon Health Sciences University (A.S.), Portland, Oregon 97201

Address all correspondence and requests for reprints to: Francesco Chiarelli, M.D., Clinica Pediatrica, Ospedale Policlinico, Via dei Vestini 5, 66100 Chieti, Italy. E-mail: chiarelli{at}unich.it

Abstract

This study was designed to evaluate whether vascular endothelial growth factor serum concentrations may identify adolescents with onset of type 1 diabetes during childhood at greater risk to develop persistent microalbuminuria and incipient diabetic nephropathy. In January 1989, vascular endothelial growth factor serum levels were measured in 101 normoalbuminuric diabetic children and adolescents (aged 7–14.9 yr; onset of diabetes before age 18 yr; duration of diabetes >7 yr). Participants were clinically examined at baseline and annually thereafter. Vascular endothelial growth factor serum concentrations were measured every year during the 8-yr follow-up period. Over 8 yr, 11 of 101 patients (10.9%) developed persistent microalbuminuria; no patient developed overt nephropathy. The risk of developing microalbuminuria was higher in children with increased vascular endothelial growth factor serum levels (using 160 pg/ml as the arbitrary cut-off point; group 1) compared with those with normal vascular endothelial growth factor serum levels at the beginning of the study (group 2; 19.2 vs. 2.0%; P < 0.01; sensitivity, 90.9%; specificity, 53.3%). The odds ratio for the occurrence of microalbuminuria after adjustment for confounding variables (albumin excretion rate, sex, hemoglobin A_1c, mean blood pressure, cholesterol, and triglycerides) in type 1 diabetic adolescents with elevated vascular endothelial growth factor serum levels was 4.1 (95% confidence interval, 2.0–10.9).

These results suggest that vascular endothelial growth factor serum concentrations may be one of the predictors and risk factors for microalbuminuria and incipient diabetic nephropathy in adolescents and young adults with onset of diabetes during childhood. Persistently increased vascular endothelial growth factor serum levels may help to identify normotensive, normoalbuminuric patients with type 1 diabetes who are predisposed to develop persistent microalbuminuria later in life.

This article has been cited by other articles:

				A. Ashraf, G. Mick, S. Meleth, H. Abdullatif, X. Wang, and K. McCormick Effect of Insulin on Plasma Vascular Endothelial Growth Factor in Children with New-Onset Diabetes J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4920 - 4923. [Abstract] [Full Text] [PDF]

				D. R. Cha, Y. S. Kang, S. Y. Han, Y. H. Jee, K. H. Han, J. Y. Han, Y. S. Kim, and N. H. Kim Vascular endothelial growth factor is increased during early stage of diabetic nephropathy in type II diabetic rats J. Endocrinol., October 1, 2004; 183(1): 183 - 194. [Abstract] [Full Text] [PDF]