Angiopoietic factors and retinopathy in pregnancies complicated with Type 1 diabetes

Aims To evaluate the role of systemic angiopoietic factors in the progression of diabetic retinopathy during pregnancy. Methods In a prospective study of 26 pregnant women with diabetes and eight non-diabetic pregnant women, retinopathy was graded from fundus photographs. Plasma levels of angiopoietin-1, angiopoietin-2, human vascular endothelial growth factor A (hVEGF-A), and total soluble receptor of vascular endothelial growth factor (sVEGF) receptor-1 were measured during the first and third trimester and 3 months postpartum. Results In diabetic women, levels of angiopoietin-2 were 26.5 ng/ml (12.1–47.7) (median and range) during the first trimester, 2.9 ng/ml (0.6–3.5) during the third trimester, and 0.5 ng/ml (0.3–0.7) 3 months postpartum, compared with 44.3 (38.3–61.9), 5.7 (3.1–8.4) and 0.9 (0.6–4.9) ng/ml, respectively, in non-diabetic women (P = 0.002 between groups). Levels of angiopoietin-1 and sVEGF receptor-1 did not differ between the groups. Postpartum hVEGF-A levels were lowest in women with progression of retinopathy. In logistic regression analyses, progression of retinopathy during pregnancy was not explained by the levels of the angiopoietic factors. Conclusions The circulating levels of angiopoietic factors in pregnant diabetic women were either lower than (Ang-2) or similar to (Ang-1, hVEGF-A, VEGFR-1) those levels observed in non-diabetic pregnant women. The levels of angiopoietic factors measured here appear not to be connected with the progression of retinopathy during pregnancy.