Erythropoietin and vascular endothelial growth factor as risk markers for severe hypoglycaemia in type 1 diabetes

P L Kristensen, U Pedersen-Bjergaard, C Schalkwijk, Niels Vidiendal Olsen, B Thorsteinsson

5 Citations (Scopus)

Abstract

OBJECTIVE: Circulating erythropoietin (EPO) and vascular endothelial growth factor (VEGF) increase during hypoglycaemia and may represent protective hormonal counter-regulatory responses. We tested the hypothesis that low levels of EPO and VEGF are associated with a higher frequency of severe hypoglycaemia in a cohort of patients with type 1 diabetes.

DESIGN: Prospective observational follow-up study.

METHODS: Totally 219 patients with type 1 diabetes (41% females, age 46+/-13 years (mean+/-s.d.), duration of diabetes 21+/-12 years, and HbAlc 8.5+/-1.1%) were followed in a 1-year observational study. Plasma EPO and serum VEGF levels were measured at baseline with ELISA. Events of severe hypoglycaemia defined by third party assistance were recorded and validated in telephone interviews within 24 h.

RESULTS: Totally 235 episodes of severe hypoglycaemia (1.1 episodes per patient-year) were reported by 82 patients (37%). At baseline, plasma EPO was 8.6 (3.1-34.3) U/l (median (range)), and serum VEGF was 52.2 (6.6-337) pg/ml. The levels of EPO and VEGF were not associated with frequency of severe and mild hypoglycaemia. The levels of EPO were not associated with age, sex, duration of diabetes, body mass index, HbAlc, C-peptide level or hypoglycaemia awareness status. The levels of VEGF were positively associated with age and female sex.

CONCLUSIONS: Although several studies suggest that VEGF and EPO may affect brain function during hypoglycaemia, this study does not support random VEGF or EPO levels to determine future risk of severe hypoglycaemia in people with type 1 diabetes.

Original languageEnglish
JournalEuropean Journal of Endocrinology. Supplement
Volume163
Issue number3
Pages (from-to)391-8
Number of pages8
ISSN0804-4635
DOIs
Publication statusPublished - 1 Sept 2010

Keywords

  • Adult
  • Age Factors
  • Biological Markers
  • Diabetes Mellitus, Type 1
  • Erythropoietin
  • Female
  • Follow-Up Studies
  • Humans
  • Hypoglycemia
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Vascular Endothelial Growth Factor A

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