Relationship between plasma angiogenic growth factors and diabetic foot ulcers

Background: Angiogenic growth factors play an important role in wound healing. However, their associations with diabetic foot ulcers (DFUs) in humans have rarely been investigated. We examined the relationships between circulating concentrations of vascular endothelial growth factor (VEGF)-A and placenta growth factor (P1GF), and DFU risk. Methods: We recruited 447 participants, including 169 DFU patients, 182 diabetes patients without DFUs, and 96 diabetes-free individuals. Plasma VEGF-A and PIGF concentrations were measured using commercial enzyme immunoassay kits. Results: Concentrations of VEGF-A and P1GF in DFU patients were higher than those in diabetes-free controls (P < 0.05), but lower than those in the diabetic controls (P < 0.05). Increased concentrations of VEGF-A and PIGF were associated with a reduced risk of DFUs. The odds ratios (95% confidence intervals) were 0.93 (0.88, 0.97) for every 10 pg/ml increase in VEGF-A concentrations, and 0.96 (0.94, 0.99) for every 5 pg/ml increase in P1GF concentrations. VEGF-A concentrations were positively related to BMI, glycated hemoglobin (HbAlc), hypertension, and neuropathy, and PIGF was positively correlated to age, HbAlc, and hypertension, among DFU patients. Conclusion: VEGF-A and P1GF play important roles in the development of DFU but need to be confirmed in prospective studies.