Aim: To evaluate the expression of eNOS and CD34 in gastric mucosa of Helicobacter pylori (H. pylori) positive diabetic patients, in correlation with glycaemic control and diabetic autonomic neuropathy (DAN).
Methods: We prospectively studied 49 diabetic type 2 patients (29 women, mean age 65.32+/-8.56 years) and 30 control subjects (15 women, mean age 58.47+/-12.40) that underwent endoscopy. Biopsies from the body and antrum were evaluated for H. pylori-gastritis, eNOS and angiogenic marker CD34 expression. Statistical analysis in correlation with mean glycosylated haemoglobin (HbA1c) of the last 3 years, and DAN was performed.
Results: The two groups were matched for age (p=0.144), sex (p=0.335), H. pylori-infection (p=0.617) and degree of gastritis (p=0.78). eNOS and CD34 attenuated expression correlated with diabetes mellitus (DM) in the corpus (p=0.009 and 0.02, respectively). eNOS and CD34 expression was upregulated in H. pylori-positive controls but not in H. pylori-positive diabetic patients (p=0.010 and 0.007 for the corpus and p=0.036 and 0.047 for the antrum, respectively). eNOS expression correlated with good glycaemic control (GGC) in the gastric corpus (p<0.001) and antrum (p=0.0037) and with absence of DAN (p=0.009 and 0.036, respectively for the corpus and antrum).
Conclusion: Chronic glycaemic control affects eNOS expression and angiogenesis in the gastric mucosa of patients with type 2 DM. eNOS expression is not upregulated in H. pylori-positive diabetic patients.