Relations between von Willebrand factor, markers of oxidative stress and microalbuminuria in patients with type 2 diabetes mellitus

Background: To assess the relations among plasma levels of von Willebrand factor (vWf), microalbuminuria and markers of oxidative stress in patients with type 2 diabetes mellitus. Material/Methods: We studied 10 healthy subjects without microalbuminuria or history of coronary artery disease (CAD) and 30 patients with type 2 diabetes mellitus who were classified into three groups, each including 10 patients of matched age and sex; group 1: patients without microalbuminuria or history of CAD; group 2: patients with microalbuminuria and no history of CAD, and group 3: patients with microalbuminuria and history of CAD. All subjects underwent laboratory measurements of vWf, albumin excretion rate (AER), malondialdehyde, vitamin C, reduced glutathione and C peptide. Results: vWf was elevated in patients with type 2 diabetes mellitus compared with control subjects. However, levels were higher in patients with than without microalbuminuria and in patients with than without a history of CAD (96 +/- 12, 124 +/- 7, 149 +/- 9, 175 +/- 7 in the control subjects and the diabetic patients' groups respectively). There was a positive correlation between vWf and AER, MDA and C- peptide (r = 0.91, 0.98, 0.96, p < 0.0001) and a negative correlation between vWf and both vitamin C and reduced glutathione (r = -0.59 and -0.62 respectively, p < 0.001). Conclusions: vWf levels are elevated in patients with type 2 diabetes mellitus, particularly in the presence of microalbuminuria and history of CAD. vWf levels are associated with markers of increased oxidative stress and therefore reflect the severity of biochemical abnormalities, which contribute to diabetic vascular disease.