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Submitted on March 24, 2005
Accepted on May 18, 2005
Department of Pediatrics/Division of Pediatric Endocrinology and Metabolism, The Children's Hospital, University of Alabama at Birmingham and The Department of Biostatistics and bio informatics unit, Comprehensive Cancer Center, UAB School of Medicine, Birmingham
* To whom correspondence should be addressed. E-mail: AAshraf{at}peds.uab.edu.
Considerable experimental evidence inculpates vascular endothelial growth factor (VEGF) as one of the candidate factors providing a mechanistic link between hyperglycemia and diabetic complications.
Aim: To assess the effect of insulin treatment and glycemic control on plasma VEGF levels in children with new onset diabetes.
Methods: This prospective study assessed the changes in plasma VEGF levels after treatment of diabetes with insulin. We also aimed to ascertain if there was any correlation between plasma VEGF levels and simultaneous random plasma glucose. The study comprised 19 children with new onset diabetes mellitus, between ages 3-18 yr. The control group comprised of 55 healthy non diabetic children with idiopathic short stature.
Results: Plasma VEGF concentrations were significantly elevated in children at diagnosis of diabetes compared with healthy controls (P < 0.0002). Plasma VEGF levels (P < 0.01) and HbA1C (P < 0.0001) declined in diabetic children post insulin treatment. There was a highly significant correlation between reduction in plasma VEGF levels and HbA1C levels (r=0.65, P < 0.037). We did not find any correlation between the simultaneous plasma glucose values and basal VEGF.
Conclusions: Presence of hyperglycemia and/ or insulin deficiency in children with new onset of diabetes is associated with plasma VEGF elevation, even at the outset of disease, and this can be mitigated by insulin therapy.
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