Role of serum HIF-1alpha and VEGF-A as an angiogenic factors in women with heavy menstrual bleeding

Aim: The purpose of this study to evaluate the levels of potent angiogenic factors, such as VEGF-A (Vascular Endothelial Growth Factor-A) and HIF-1 alpha (Hypoxia Induced Factor) in patients with Heavy Menstrual Bleeding (HMB). In addition, serum copper and ceruloplasmin as modulator of angiogenesis were investigated. We evaluated haemoglobin concentration and ET (Endometrial Thickness) as clinical and laboratory features of disease to investigate role of angiogenesis in etiology of HMB. Methods/Analysis: This case-control study was conducted on 120 females aged between 22-48 years with history of bleeding excessively for more than 3 months and 120 control samples. 5 ml of blood sample was collected from HMB patients and controls. Serum HIF-1 alpha, VEGF-A were measured by ELISA kit method. Copper was estimated using 3,5-dibromo-2-pyridylazo-N-ethyl-N-3 sulphopropyl aniline. Ceruloplasmin was estimated using P-Phenylenediamine (PPD) oxidase method. Endometrial thickness was obtained from Ultrasonography (USG). Hemoglobin was estimated using Drabkin's method. Findings: We observed higher concentration of VEGF-A as well as HIF-1 alpha in patient with HMB as compared to healthy women. The ROC (Receiver Operating Characteristic) curve was used to obtain optimal cutoffof VEGF-A as well as HIF-1 alpha to discriminate the HMB. Conclusion: Increase serum HIF-1alpha, VEGF-A and copper might be seen as predictors of HMB and increase efficacy of treatment.