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ECPB 2017, 80(4): 40–45
https://doi.org/10.25040/ecpb2017.04.040
Research articles

Serum Levels of Fibronectin in Type 1 Diabetes Patients with Microangiopathy and Arterial Hypertension

L.A. MOGYLNYTSKA
Abstract

Aim. To determine the serum level of fibronectin as a marker of endothelial dysfunction in type 1 diabetes patients with microangiopathy, to study of the association of arterial hypertension and the level of this factor, its relationship with other risk factors for cardiovascular disease. Materials and methods. We have examined 23 hypertensive type 1 diabetes patients with microangiopathy: age 20,34 ± 2,05 years, duration of the disease 11,56 ± 3,18 years, HbA1c 10,74 ± 1,52 %, fasting blood glucose 11,26 ± 2,1 mmol/l, total cholesterol 5,61 ± 0,7 mmol/l, HDL 0,97 ± 0,17 mmol/l, LDL 3,56 ± 1,02 mmol/l, triglycerides 2,64 ± 0,51 mmol/l, systolic blood pressure 162,17 ± 12,95 mmHg, diastolic blood pressure 100,87 ± 5,36, 52,17 % treated with antihypertensive drugs, 47,82 % – non- treated.

10 non-hypertensive type 1 diabetic patients with microangiopathy: age 20,3 ± 2,21 years, duration of the disease 10,87 ± 3,72 years, HbA1c 9,88 ± 1,76 %, fasting blood glucose 10,08 ± 2,68 mmol/l, total cholesterol 5,15 ± 1,41 mmol/l, HDL 1,11 ± 0,24 mmol/l, LDL 3,11 ± 1 mmol/l, triglycerides 2,3 ± 0,56 mmol/l; and 28 healthy control subjects: age 19,96 ± 2,06 years, HbA1c 5,33 ± 0,45 %, fasting blood glucose 4,6 ± 0,57 mmol/l, total cholesterol 4,14 ± 0,51 mmol/l, HDL 1,34 ± 0,23 mmol/l, LDL 2,63 ± 0,4 mmol/l, triglycerides 1,46 ± 0,29 mmol/l.

52,17 % hypertensive type 1 diabetic patients with microangiopathy have proliferative diabetic retinopathy, 30,43 % – preproliferative diabetic retinopathy, 13,04 % – non-proliferative, 100 % – diabetic nephropathy IV(Mogensen C.E.). 30 % non-hypertensive type 1 diabetic patients with microangiopathy have proliferative diabetic retinopathy, 10 % – preproliferative diabetic retinopathy, 40 % – non-proliferative, 50 % – diabetic nephropathy IV, 50 % – diabetic nephropathy III (Kohner Å., Porta M.). All patients don’t use hypolipidemic drugs.

Serum levels of fibronectin have been determined by immunoenzyme assay. The data have been presented as means ± SD. Statistical analysis has been performed using the Mann – Whitney U-test, Pearson rank correlation coefficient, multiple regression analysis.

Results. Serum level of fibronectin in hypertensive type 1 diabetic patients with microangiopathy has been 382,57 ± 39,73 pmol/ml, non-hypertensive diabetic patients – 295,96 ± 83,91 pmol/ml, in control group – 202,71 ± 47,34 pmol/ml. We have found an increased serum level of fibronectin in hypertensive type 1 diabetic patients with microangiopathy compared to control group (88,72 %, ð < 0,01), in non-hypertensive type 1 diabetic patients with microangiopathy compared to control group (46 %, ð < 0,01) and in hypertensive type 1 diabetic patients with microangiopathy compared to group of non-hypertensive diabetic patients (29,26 %, ð < 0,01). Also, the level of fibronectin has correlated with HbA1c (r = 0,82; p < 0,05), fasting blood glucose (r = 0,78; p < 0,05), total cholesterol (r = 0,58; p < 0,05), HDL (r = -0,69; p < 0,05), LDL (r = 0,68; p < 0,05), triglycerides (r = 0,64; p < 0,05) in hypertensive type 1 diabetic patients with microangiopathy and HbA1c (r = 0,49; p < 0,05), fasting blood glucose (r = 0,58; p < 0,05), total cholesterol (r = 0,28; p < 0,05), HDL (r = -0,77; p < 0,05), LDL (r = 0,3; p < 0,05), triglycerides (r = 0,48; p < 0,05) in non-hypertensive type 1 diabetic patients with microangiopathy. Conclusion. The revealed changes of fibronectin serum levels could reflect an endothelial dysfunction in patients with type 1 diabetes with microangiopathy and arterial hypertension. Arterial hypertension, hyperglycemia, dyslipidemia appear to be significant contributing factor to the elevation of fibronectin.

Added: 17.10.2017

Keywords: fibronectin, endothelial dysfunction, type 1 diabetes, arterial hypertension

Full text: PDF (Ukr) 3.48M

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