Albuminuria and VEGF as early markers of cardiovascular disturbances in young type 1 diabetic patients

AimsThe aim of the study was to assess myocardial perfusion by means of non-invasive diagnostic methods and measurement of the plasma concentration of vascular endothelial growth factor (VEGF) in patients with long-lasting type 1 diabetes.Methods and resultsThe study was performed on 41 Type 1 diabetic patients (23 females, 18 males), aged 30 ± 7.6 with a duration of disease 15.2 ± 5.5 years. 17 patients exhibited microalbuminuria (10 females, 7 males) and 24 subjects were without microalbuminuria (13 females, 11 males). The methods used included a 24-h ECG tape, an exercise treadmill test, echocardiological evaluation with dobutamine and atropine challenge and single photon emission computer tomography (SPECT) at rest, and after dipyridamol induction of ischemia. All the exercise and stress echocardiography tests were negative. There were significant differences between microalbuminuric and normoalbuminuric subjects in the duration of their exercise tests (586.9 ± 110.5 vs. 664.9 ± 133.2 s, p = 0.027), performed work (11.4 ± 1.6.vs. 12.6 ± 1.8 METs, p = 0.045), achieved pulse limit (89.1 ± 3.6 vs. 92.6 ± 5.2%, p = 0.037), rest ejection fraction (55.8 ± 8.7 vs. 62.0 ± 4.4%, p = 0.040), abnormal changes in SPECT (53 vs. 21%, p = 0.047) and VEGF concentration (101.5 ± 7.8 vs. 75.15 ± 16.5 pg/ml, p < 0.05). The presence of retinopathy increased 12-fold the probability of significant changes in the SPECT (OR 12.1, 95% CI 1.38–105.64, p = 0.02) and nephropathy (OR 4.27; 95%CI 1.09–16.83, p = 0.03).ConclusionAsymptomatic patients with long lasting type 1 diabetes may have disturbances in myocardial perfusion, especially these with microalbuminuria.