The pathogenetic significance of endothelial dysfunction in the development of diabetic nephropathy in patients with type 2 diabetes mellitus

Objective: to determine the level of circulating markers of endothelial dysfunction (endothelin‑1, von Willebrand factor (vfV), endothelial NO-synthase (e‑NOS)) in the blood serum of patients with type 2 diabetes mellitus (DM), as well as to assess the pathogenetic significance endothelial dysfunction in the development of diabetic nephropathy.Materials and methods: the study included 93 patients with type 2 DM, including 28 men (30.1%) and 65 women (69.9%), aged 30 to 79 years, the average age of patients was 59.7±8.4 of the year. The main group included patients with both newly diagnosed type 2 DM and a long-term diabetic history. The duration of the disease averaged 9.5±7.5 years. The majority of patients with DM type 2 (92.5%) at the time of inclusion in the study had various variants of microvascular complications of diabetes, only a small number of patientsin this group (7.5%) had no signs of diabetic angiopathy. Signs of various stages of diabetic nephropathy were observed in 60 patients (69.2%). The comparison group consisted of 30 patients with essential arterial hypertension, including 12 men (40%) and 18 women (60%), aged 34 to 70 years, on average 56.1 ± 8.1 years. The control group consisted of 32 apparently healthy individuals. In all patients, along with routine methods of clinical, laboratory and instrumental examination, the level of circulating markers of endothelial dysfunction (endothelin‑1, von Willebrand factor (vWF), endothelial NO-synthase (e‑NOS)) in blood serum was measured using enzyme-linked immunosorbent assay (ELISA).Results: in patients with DM type 2 and diabetic nephropathy, a statistically significant increase in the concentration of circulating markers of endothelial dysfunction was revealed in comparison with hypertensive patients and healthy individuals. An increase in the level of endothelin‑1 relative to the borderline reference value was found in 73 (78.5±4.1%), vfV in 63 (67.7±4.8%) and e‑NOS in 65 (69.9±4.7%) of patients with DM type 2. In the groups of participants with hypertension and healthy individuals, endothelial imbalance was noted by us significantly less often than in patients with DM type 2, the levels of endothelin‑1 and vfV in people with hypertension were increased in more cases than in healthy individuals. It was noted that the levels of circulating markers of endothelial dysfunction increase with an increase in the duration of DM type 2, and also significantly increase under conditions of carbohydrate decompensation.Conclusion: the results obtained confirm the pathogenetic role of endothelial dysfunction in the development of diabetic nephropathy in patients with type 2 diabetes, increasing endothelial imbalance in persons with a long diabetic history and lack of compensation for carbohydrate metabolism.

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Elevated levels of plasma von Willebrand factor and increased urinary albumin excretion are possible markers for endothelial dysfunction in type 2 diabetes mellitus patients

Indian Journal of Clinical Anatomy and Physiology ◽

10.18231/2394-2126.2018.0109 ◽

2018 ◽

Vol 5 (4) ◽

pp. 468-473

Author(s):

Suresh Nayak B ◽

Umadevi B

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Endothelial Dysfunction ◽

Von Willebrand Factor ◽

Urinary Albumin Excretion ◽

Urinary Albumin ◽

Von Willebrand ◽

Willebrand Factor

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Increased plasma levels of endothelin 1 and von Willebrand factor in patients with type 2 diabetes and dyslipidemia

Diabetes Care ◽

10.2337/diacare.23.9.1395 ◽

2000 ◽

Vol 23 (9) ◽

pp. 1395-1400 ◽

Cited By ~ 68

Author(s):

B. G. Seligman ◽

A. Biolo ◽

C. A. Polanczyk ◽

J. L. Gross ◽

N. Clausell

Keyword(s):

Type 2 Diabetes ◽

Von Willebrand Factor ◽

Plasma Levels ◽

Endothelin 1 ◽

Von Willebrand ◽

Willebrand Factor

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Markers of Endothelial Dysfunction: E-selectin, Endothelin-1 and von Willebrand Factor in Patients with Coronary Heart Disease, Including in Combination with Type 2 Diabetes Mellitus

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-6-892-899 ◽

2020 ◽

Vol 15 (6) ◽

pp. 892-899 ◽

Cited By ~ 1

Author(s):

A. V. Zhito ◽

A. O. Iusupova ◽

E. V. Privalova ◽

N. V. Khabarova ◽

Yu. N. Belenkov

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

Endothelial Dysfunction ◽

Cell Adhesion Molecules ◽

Von Willebrand ◽

Willebrand Factor

The prevalence of coronary heart disease (CHD) and type 2 diabetes mellitus (type 2 diabetes) in Russia and in the world continues to increase. Despite the prevention and optimization of therapy, CHD retains its leadership among all causes of death, and the mortality rate from type 2 diabetes and its complications gradually increases too. To improve the treatment of the above mentioned diseases, it is necessary to clarify the pathogenetic mechanisms of their development. The formation of endothelial dysfunction, characterized by an increase in the level of cell adhesion molecules and vasoconstriction, is a common link characteristic for the course and progression of CHD and type 2 diabetes. This article presents an analysis of preand clinical studies on the role of endothelial dysfunction markers: cell adhesion molecules (E-selectin), vasoconstriction (endothelin-1) and von Willebrand factor in patients with CHD, including those with type 2 diabetes mellitus.

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Elabela levels in patients with type 2 diabetes: can it be a marker for diabetic nephropathy?

African Health Sciences ◽

10.4314/ahs.v20i2.37 ◽

2020 ◽

Vol 20 (2) ◽

pp. 833-840

Author(s):

Erhan Onalan ◽

Yusuf Doğan ◽

Ebru Onalan ◽

Nevzat Gozel ◽

Ilay Buran ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

High Serum ◽

Control Group ◽

Diabetic Patients ◽

Healthy Individuals ◽

Urine Albumin ◽

Healthy Control ◽

Group 2

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.

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