To compare circulating pigment epithelium derived factor (PEDF)
levels in type 2 diabetes patients (T2D) with and without
metabolic syndrome (MetS+/-) to healthy controls and assess
PEDF association with plasminogen activator inhibitor-1 (PAI-1)
and von Willebrand factor (vWF) as markers of endothelial
dysfunction. Fifty T2D individuals and forty healthy controls were
included. PEDF, PAI-1, vWF, anthropological parameters, lipids,
and markers of insulin resistance were investigated in all
subjects. Compared to controls only MetS+ diabetics had higher
PEDF levels [14.2 (10.2-16.0) mg/l vs. 11.1 (8.6-14.4) mg/l;
p<0.05]. PEDF significantly correlated: positively with body mass
index (ρ=0.25), smoking (ρ=0.21), C-reactive protein (ρ=0.22),
triglycerides (ρ=0.38), non-HDL-cholesterol (ρ=0.39),
apolipoprotein B (ρ=0.38), fasting glucose (ρ=0.22), glycated
hemoglobin (ρ=0.24), C-peptide (ρ=0.28), insulin (ρ=0.26); and
negatively with HDL-cholesterol (ρ=-0.42) and apolipoprotein A1
(ρ=-0.27). Independent association of PEDF with vWF in
T2DMetS- subjects was found. Significantly elevated PEDF in
T2DMet+ patients and its association with adverse metabolic
profile confirmed PEDF as a marker of insulin resistance.
Negative independent association of PEDF with vWF in T2DMetSpatients may reveal its angio-protective role.
Von Willebrand disease is a commonly inherited bleeding disorder caused by defects of von Willebrand factor (vWF). In the most common valve diseases, aortic valve stenosis (AVS) and mitral valve regurgitation (MVR), a bleeding tendency has been described in a number of patients. This has been associated to a high turbulence of blood flow through the compromised valve, promoting degradation of vWF with loss of high-molecular-weight multimers of vWF (HMWM), leading to an acquired von Willebrand syndrome (AvWS). We analysed three groups of patients, one affected by AVS, treated with transcatheter aortic valve implantation (TAVI), the second group of patients affected by MVR, treated with Mitraclip® mitral valve repair. The third group was represented by patients also affected by AVS, but not eligible for TAVI and treated with standard surgery. A fourth group of patients that underwent percutaneous coronary intervention (PCI) with stenting was used as a control. Our results demonstrated that the level of vWF measured as antigen concentration (vWF:Ag) increases in all cohorts of patients after treatment, while in control PCI patients, no modification of vWF:Ag has been registered. Western blot analysis showed only a quantitative loss of vWF in the pre-treatment time, but without significant HMWM modification. The monitoring of the vWF:Ag concentration, but not the quality of HMWM, can indicate the status of blood flow in the treated patients, thus introducing the possibility of using the vWF antigen detection in monitoring the status of replaced or repaired valves.