Volume 1 number 1 Summer 2003
Special issue for the abstracts of the 7th Pan Arab Conference on Diabetes
PACD7 , 25 – 28 March 2003 Cairo

Abstract Number : 87
VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) IN EGYPTIAN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
RELATION TO GLYCEMIC CONTROL AND VASCULAR DIABETIC COMPLICATIONS
By 

Dr. Azza Abdel Gawad Tantawy
Professor of Pediatrics
Ain Shams University , Egypt

Diabetes mellitus is characterized by microangiopathy and increased angiogenic response to various agents. Vascular endothelial growth favtor (VEGF) is angiogenic and is responsible for vascular endothelial cell growth .The purpose of this study was to determine serum levels of VEGF in children and adolescents (youngsters) with type 1 diabetes mellitus , and correlate it with parameters reflecting the metabolic control and diabetes vasculopathy.Forty four diabetic youngsters were compared to thirty five healthy control subjects ( mean age 15.8 ± 4.9 years and 13 ± 4.7 years , respectively ) ; male to female ratio 1.6:1 and 1.5:1 , respectively).The diabetes duration varied between 0.25-14 years ( mean 6.67 ± 3.59 years) . All diabetic patients were subjected to thorough medical history and clinical examination , as well as fundus examination , measurement of nerve conduction velocity , assessment of mean random blood glucose , mean glycosylsted hemoglobin , and urinary microalbumin excretion , serum cholesterol ,and serum triglycerides. VEGF (pgLml) was measured in serum samples by enzyme immunoassays in diabetic patients and controls.There was significant elevation of VEGF in serum of type 1 diabetic patients compared to control groups (P<0.001). Diabetic patients with vascular complications ( microalbuminuria ,neuropathy , hypertension , retinopathy) had significant elevation of serum VEGF compared to diabetic patients with no evidence of vascular complications (P<0.05).A significant positive correlation was found between serum VEGF levels and one-year HbA1C values ( r=0.407 , P<0.05) , mean random blood glucose ( r=0.433 , P<0.05) , duration of diabetes ( r=0.570 , P<0.01) , serum triglycerides ( r=0.647 , P<0.01) , serum cholesterol ( r=0.371 , P<0.05) .No correlation was found between serum VEGF levels and age , sex , or insulin dose.In conclusion, serum VEGF is significantly elevated in young type 1 diabetes mellitus patients , closely related to the development od diabetic vascular disease. Assessment of serum VEGF can be used as an early predictor of diabetic vasculopathy to allow for early intervention , including proper metabolic control of hyperglycemia and lipid profile and avoidance of other risk factors of vascular disease as hypertension, obesity , smoking and sedentary life. The use of angiotensin converting enzyme inhibitors in patients with high serum VEGF levels is recommended.Further longitudinal follow up studies are required for evaluation of the sensitivity of VEGF as a monitorof vascular complications in type 1 diabetes mellitus .

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