Involvement of vascular endothelial growth factor and tumor necrosis factor-alpha in the process of neoangiogenesis in children with type 1 diabetes mellitus

Backgrounds/Aims : Neoangiogenesis is a complex process, in which crucial role seems to be played by vascular endothelial growth factor (VEGF) and tumor necrosis factor (TNF-alpha). TNF-alpha may exhibit both stimulating and inhibiting effect on angiogenesis. Therefore it appeared to be worth of analysis to investigate the relation between TNF-alpha and VEGF and the clinical course of the disease in children with Diabetes Mellitus type 1 (DM1)

Material and methods: 163 children aged 13.6±3.5 years diagnosed with DM1 from the Department of Paediatrics, Haematology, Oncology and Endocrinology at the Medical University of Gdañsk were enrolled in the study along with 60 healthy children (as the control). All the children had their daily urine albumin secretion, HbA1c, C-peptide measured; 24hrs blood pressure monitoring and ophthalmologic examination. Additionally, all of them had serum VEGF and TNF-alpha measured using highly-sensitive ELISA tests.

Results: In accordance to the daily albumin urine secretion and ophthalmologic examination, the children were divided into groups: Group A without complications, Group B with retinopathy, Group C with nephropathy and Group D with both retino- and nephropathy. Between the groups statistically significant differences in age, duration of the disease, HbA1c serum level, daily albumin urine secretion and the systolic and diastolic blood pressure were found. Besides, statistically significant differences in the VEGF level and TNF-alpha were measured. Moreover, in the group D statistically significant correlation between VEGF and TNF-alpha levels was observed.