Correlation of serum angiogenin level with various vascular complications in type 2 diabetic patients

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Abstract
Premature development of microvascular and macrovascular disease is the most frequent complication of diabetes. It is responsible for diabetic retinopathy, nephropathy, and neuropathy. Moreover, diabetes leads to reduced collateralization in ischemic tissues, which causes a three- to four-fold increase in cardiac mortality in diabetic individuals compared with nondiabetic individuals. The pathophysiological mechanisms responsible for impaired angiogenic activity in diabetes remain unknown. The role of angiogenin in the physiological revascularization process has not been clarified. This work was carried out to determine the serum angiogenin level in type 2 diabetic patients and to determine its correlation with various microangiopathies, cardiovascular complications, and the duration in type 2 diabetic patients. This work was carried out on 88 individuals, 68 type 2 diabetic patients and 20 apparently healthy controls. All individuals were subjected to the following assessments: medical history taking; clinical examination including measurement of BMI; estimation of levels of fasting blood sugar, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, urea, low-density lipoprotein, and creatinine; determination of the albumin/creatinine ratio and complete lipid profile (total cholesterol, triglyceride, high-density lipoproteins); serum angiogenin estimation by enzyme linked immunosorbent assay; fundus examination; ECG and transthoracic echocardiography; and abdominal ultrasonography. Our results indicated a significant decrease in the serum angiogenin level in diabetic patients compared with the control group; an insignificantly low serum angiogenin level in diabetic patients with retinopathy and nephropathy compared with those without retinopathy and nephropathy, respectively; a significant decrease in the serum angiogenin level in patients with coronary artery disease (CAD) compared with diabetic patients without CAD; an insignificant inverse correlation of angiogenin with fasting blood sugar, duration of diabetes mellitus with urea, and creatinine with albumin/creatinine ratio; and an insignificant proportional correlation of angiogenin with ejection fraction in diabetic patients with complications of retinopathy, nephropathy, and CAD in each group separately. This work concluded that the serum angiogenin level is lower in type 2 diabetic patients compared with the control group and it decreases with prolonged duration of diabetes, especially in uncontrolled patients and patients with microangiopathic and cardiovascular complications. As angiogenin is one of most powerful angiogenic factors, we recommend further studies to evaluate the diagnostic, prognostic, and therapeutic value of angiogenin in various microangiopathic and cardiovascular complications of type 2 diabetes.

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