Vascular endothelial growth factor at diagnosing diabetic polyneuropathy and prevention of diabetic foot syndrome
Purpose of the study: to determine the prognostic significance of the vasculoendothelial growth factor in the diagnosis of macroangiopathic complications of diabetic polyneuropathy and the prevention of diabetic foot syndrome. Materials and methods. 68 patients with diabetes mellitus aged 58.5±14.8 years were examined. There were 66.2% women and 33.8% men. The duration of diabetes mellitus averaged 9.5±5.7 years. The comparison group consisted of 11 practically healthy individuals. Clinical examination included questionnaires NSS, TSS, MNSI scales, NDS scale neurological examination, lower limb electroneuromyography (ENMG), laboratory determination of glycated hemoglobin, vasculoendothelial growth factor (VEGF-A) in serum. Results. The serum level of VEGF-A in patients with clinically manifested DPN (46.4±13.75 pg/ml) significantly exceeded the serum VEGF of patients without DPN (34.53±15.37 pg/mL, p<0.05), and serum content VEGFA of patients with diabetic foot syndrome (20.55±7.11 pg/ml, p<0.001). Correlations between the quantitative contents of VEGF and the duration of diabetes mellitus and the degree of axonal damage of nerve fibers according to ENMG data were obtained. Conclusions. The study testify to the important role of endothelial dysfunction in the progression of axonopathy, which allows us to consider the enhancement of the expression of the vasculoendothelial growth factor as a marker of developing diabetic polyneuropathy and its deficiency in the serum as a predictor of the development of the diabetic foot syndrome.