Study On The Changes And Significance Of Hypoxia Inducible Factor-1α In Type2Diabetes And Its Peripheral Neuropathy

ObjectiveTo detect the levels of hypoxia inducible factor-1α (HIF-1α) and vascular endothelialgrowth factor (VEGF) in diabetic patients with or without peripheral neuropathy andhealthy subjects. To investigate the changes of serum levels of HIF-1α and VEGF indiabetes, their influencing factors and the relationships with diabetic peripheral neuropathy(DPN). To analyze the risk factors for diabetic peripheral neuropathy.MethodsDepending on whether the merger of diabetic peripheral neuropathy,99patients withtype2diabetes were divided into two groups, the DM group (T2DM, n=51) and diabeticperipheral neuropathy group (DPN, n=48),42healthy subjects were taken as control group(NC, n=42). Enzyme-linked immunosorbent assay (ELISA) was used to determinate thelevel of serum HIF-1α and VEGF. Biochemical indicators of the three groups were testedand the age and duration of disease were recorded down. The serum HIF-1α and VEGFlevels and the influencing factors were analyzed among the three groups and risk factorsfor DPN were discussed.Results1. The serum levels of HIF-1α and VEGF in group T2DM were (635.26±180.56),(51.18±24.72), and in group DPN were (486.23±136.01),(36.12±19.34), both of themwere significantly higher than that of group NC (165.85±61.30),(10.92±2.64),(p<0.01).The patients in group T2DM had higher serum levels of HIF-1α and VEGF than that ingroup DPN（p<0.01）. Both group T2DM and group DPN had higher levels of BMI, FPG,HbA1c, TG and SBP than that of group NC (p<0.05and p<0.01respectively). The durationof disease and the level of HbA1c in group DPN were higher than that in group T2DM（p<0.05and p<0.01respectively). 2.Multiple regression analysis showed the duration of the disease, levels of HbA1c andFPG were negatively correlated with serum levels of HIF-1α and VEGF. Result of Pearsonmethod for the analysis of correlation showed serum levels of HIF-1α and VEGF weresignificantly positively correlated in three groups (p<0.01).3.Logistic regression analysis showed the duration of diabetes and the level of HbA1cwere significant risk factors for DPN (p<0.01).Conclusions1.The increased serum levels of HIF-1α and VEGF in diabetics with or withoutperipheral neuropathy have protective effects on early diabetes and DPN.2.The prolonged duration of disease and the toxicity of high blood glucose eventuallylead to decrease of serum HIF-1α and VEGF levels. Lack of this protection mechanismmay be one of the causes of DPN.3.The duration of diabetes and the level of HbA1c are significant risk factors for DPN.Severe continued hypoxia can lead HIF-1α to be cell toxicity and aggravate DPN.