High vitreous concentration of vascular endothelial growth factor in diabetic patients with proliferative retinopathy using statins

Figures & data

Table I. Clinical characteristics of diabetic patients and non‐diabetic control subjects. The data are expressed as means and standard deviation in parentheses, except for vitreous VEGF, which is presented as median and range.

	Non‐diabetic control subjects		Diabetic patients without proliferative retinopathy		Diabetic patients with proliferative retinopathy
	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n
Age (years)	65.5 (14.4)	43	58.3 (15.6)	21	57.3 (13.8)	50
Gender (M/F)	18/25	43	8/13	21	25/25	50
Fasting plasma glucose (mmol/L)	5.2 (0.7)	43	8.7 (7.4)	21	9.5 (4.2)	49
Glycated haemoglobin (%)	5.56 (0.49)	43	8.4 (3.1)	21	8.8 (1.6)	49
Duration of diabetes (years)	‐	‐	7.7 (1.8)	21	19.1 (9.9)	50
Systolic blood pressure (mmHg)	148 (20)	43	154 (18)	21	155 (23)	48
Diastolic blood pressure (mmHg)	86 (11)	43	84 (10)	21	84 (12)	48
Plasma cholesterol (mmol/L)	5.15 (1.03)	43	4.67 (1.07)	21	4.90 (1.06)	50
LDL cholesterol (mmol/L)	3.33 (0.89)	43	2.78 (0.96)	21	2.94 (0.89)	50
HDL cholesterol (mmol/L)	1.41 (0.40)	43	1.33 (0.41)	21	1.24 (0.31)	50
Triglycerides (mmol/L)	1.38 (0.60)	43	1.83 (0.85)	21	1.99 (1.21)	49
Creatinine (μmol/L)	78 (21)	43	75 (25)	21	92 (49)	50
Plasma VEGF (pg/mL)	172 (101)	43	127 (85)	20	163 (91)	49
Vitreous VEGF (pg/mL):		42		21		53
Mean (SD)	48 (112)		424 (753)		1383 (1534)
Median (range)	9 (0–631)		119 (9–3351)		744 (117–7110)

LDL = low‐density lipoprotein; HDL = high‐density lipoprotein; VEGF = vascular endothelial growth factor

Table II. Clinical characteristics of the diabetic subjects.

	Diabetic patients with proliferative retinopathy	Diabetic patients without proliferative retinopathy
	n (%)	n (%)
Diabetes type:
Type 1	26 (52%)	3 (14%)
Type 2	24 (48%)	18 (86%)
Medication:
Insulin	38 (76%)	9 (43%)
Oral diabetes medication	19 (38%)	9 (43%)
ACE inhibitor	29 (56%)	11 (52%)
Statin	15 (30%)	10 (48%)
Complications:
Nephropathy (mild)	19 (38%)	4 (19%)
Neuropathy	17 (34%)	3 (14%)
Laser:
Macular laser	8 (16%)	9 (43%)
Panretinal laser	42 (84%)	3 (14%)

ACE = angiotensin‐converting enzyme

Figure 1 Vitreous VEGF concentration in diabetic patients with proliferative retinopathy according to statin use or ACE inhibitor use. The data are expressed as follows: black line inside the box indicating median; box between 25 and 75 percentiles; whiskers, 5 and 95 percentiles. ACE = angiotensin‐converting enzyme; VEGF = vascular endothelial growth factor.

Table III. Diabetes duration, glycaemic control, blood pressure and vitreous VEGF, in non‐diabetic control subjects, diabetic patients without proliferative retinopathy, or in diabetic patients with proliferative retinopathy according to statin medication. The data are expressed as means and standard deviation for others, and vitreous VEGF as median and range. The n for vitreous VEGF is shown in parentheses. Statistical testing was done between diabetic groups with ANOVA, except for vitreous VEGF where Kruskal‐Wallis was used.

	Non‐diabetic control subjects	Diabetic patients without proliferative retinopathy	Diabetic patients with proliferative retinopathy without statin use	Diabetic patients with proliferative retinopathy with statin use	P
n	43	21	35	15
Duration of diabetes (years)	‐	8.7 (7.4)	18.2 (9.5)	21.7 (9.3)	0.000
Fasting plasma glucose (mmol/L)	5.2 (0.7)	8.4 (3.1)	9.6 (4.6)	9.3 (3.1)	0.632
Glycated haemoglobin (%)	5.56 (0.49)	7.7 (1.8)	8.8 (1.7)	8.8 (1.5)	0.032
Systolic blood pressure (mmHg)	148 (20)	154 (18)	153 (22)	158 (26)	0.768
Diastolic blood pressure (mmHg)	86 (11)	84 (10)	84 (12)	83 (12)	0.867
Vitreous VEGF (pg/mL)	9 (0–631)	119 (9–3351)	666 (117–7110) (n = 37)	1361 (273–6620) (n = 16)	0.000

ANOVA = analysis of variance; VEGF = vascular endothelial growth factor

Table IV. Diabetes duration, glycaemic control, blood pressure and vitreous VEGF in diabetic patients with proliferative retinopathy in the four medication groups divided according to ACE inhibitor (A) or statin (S) medication: A‐/S‐, A+/S‐, A‐/S+ and A+/S+. The data are expressed as means and standard deviation for others, and vitreous VEGF as median and range. The n for vitreous VEGF is shown in parentheses.

	A‐/S‐ n = 16	A+/S‐ n = 19	A‐/S+ n = 5	A+/S+ n = 10
Duration of diabetes (years)	16.9 (9.3)	18.7 (10.1)	24.0 (5.9)	21.0 (10.2)
Fasting plasma glucose (mmol/L)	9.3 (4.4)	9.8 (4.9)	8.4 (1.9)	9.8 (3.6)
Glycated haemoglobin (%)	8.8 (1.6)	8.8 (1.7)	7.8 (1.2)	9.4 (1.3)
Systolic blood pressure (mmHg)	158 (16)	150 (26)	141 (31)	166 (19)
Diastolic blood pressure (mmHg)	85 (13)	84 (12)	73 (13)	84 (12)
Vitreous VEGF (pg/mL)	686 (117–4421) ^c (n = 16)	589 (250–7110) ^a (n = 21)	2592 (744–5081) ^b (n = 5)	1361 (273–6620) ^d (n = 11)

^aP<0.05 between groups A+/S‐ and A+/S+ (P = 0.045)

^bP<0.05 between groups A‐/S‐ and A‐/S+ (P = 0.035)

^cP = NS between groups A‐/S‐ and A+/S‐ (P = 0.930)

^dP = NS between groups A‐/S+ and A+/S+ (P = 0.309) VEGF = vascular endothelial growth factor; ACE = angiotensin‐converting enzyme; NS = not significant