Vascular endothelial growth factor as a marker of endothelial dysfunction in poly- and comorbidity: focus on hypertension, type 2 diabetes mellitus and subclinical hypothyroidism

Abstract

Background. The goal of our study was to investigate the content and particularities of change of vascular endothe- lial growth factor-A (VEGF-A) levels as a marker of endothelial dysfunction (ED) in patients with hypertension (HT) with or without type 2 diabetes mellitus (T2DM) and with or without subclinical hypothyroidism (SH). Material and methods. Two hundred and eleven patients with hypertension stage II were divided into 3 groups: Group 1 — with HT (n = 55); Group 2 — with AH and T2DM (n = 97); Group 3 — with HT, T2DM and SH (n = 59). The patients in Group 3 were divided into 3 subgroups depending on TSH levels: 3a (n = 26) — TSH 4.0–6.0 mIU/L; 3b (n = 20) — TSH 6.1–8.0 mIU/L; 3c (n = 13) — TSH 8.1–10.0 mIU/L. We evaluated lipids, carbohydrate metabolism, serum insulin concentration, insulin resistance index — HOMA, and the level of VEGF-A in plasma. Results. The levels of VEGF-A in Group 2 was significantly lower vs. Group1 (323.94 ± 22.17 pg/mL and 413.15 ± 29.02 pg/mL, respectively (p < 0.05)). The patients in Group 3d had lower VEGF-A levels than the patients in Group 1, but higher than those in Group 2. Among Group 3 patients, the levels of VEGF-A were the lowest in the 3a subgroup (375.91 ± 19.81 pg/mL), significantly different from 3b and 3c subgroups (p < 0.05), for which no differences were found (p > 0.05.). In the 3a subgroup VEGF-A levels were significantly higher than in Group 2 patients (p < 0.05). Conclusion. These data confirms the hypothesis of increasing ED in hypothyroidism even at the subclinical level.