Glucose tolerance is negatively associated with circulating progenitor cell levels

Abstract

Aims/hypothesis Circulating progenitor cells participate in cardiovascular homeostasis. Depletion of the pool of endothelial progenitor cells (EPCs) is associated with increased cardiovascular risk. Furthermore, EPCs are reduced in the presence of classical risk factors for atherosclerotic disease, including diabetes mellitus. This study was designed to evaluate progenitor cell levels in volunteers with different degrees of glucose tolerance. Methods Cardiovascular parameters and the levels of circulating CD34 + and CD34 + kinase insert domain receptor (KDR) + cells were determined in 219 middle-aged individuals with no pre-diagnosed alterations in carbohydrate metabolism. Glucose tolerance was determined by fasting and 2 h post-challenge glucose levels, with IFG and IGT considered as pre-diabetic states. Results CD34 + and CD34 + KDR + cells were significantly reduced in individuals who were found to have diabetes mellitus, and were negatively correlated with both fasting and post-challenge glucose in the whole population. While only CD34 + cells, but not CD34 + KDR + cells, were significantly reduced in pre-diabetic individuals, postchallenge glucose was an independent determinant of the levels of both CD34 + and CD34 + KDR + cells. Conclusions/interpretation Glucose tolerance was negatively associated with progenitor cell levels in middle-aged healthy individuals. Depletion of endothelial progenitors with increasing fasting and post-meal glucose may be one cause of the high incidence of cardiovascular damage in individuals with pre-diabetes.

Reduction of both number and proliferative activity of human endothelial progenitor cells in obesity

“…Endothelial progenitor cells in obesity K Tobler et al the best of our knowledge, the relation of circulating EPCs to ApoB, lipoprotein (a) and plasma free fatty acids has not been previously studied in detail. However, in accordance with our data, cholesterol [14][15][16] and triglycerides 14,16 were already described to be ineffective on CD34 þ /KDR þ and CD45 À /CD34 þ /VEGFR-2 þ /CD133 þ EPCs, whereas heterogeneous results were found on the effects of LDL on EPC numbers. 14,16,17 Although there are several reports on reduced EPCs in diabetes, 15,16 little attention has been paid to a direct association between EPCs and glycosylated hemoglobin.…”

“…So far, the investigation of EPC number in relation to hsCRP or hypertension led to heterogeneous results. [14][15][16][18][19][20] However, for determination of extremely rare eventsFas is the case in EPC analysisFa very high number of PBMCs must be analyzed to obtain reliable results. As an aside, we had the possibility to evaluate about 30-50 times more events in this study compared with most of the previous reports.…”

Circulating endothelial progenitor cells, endothelial function, carotid intima–media thickness and circulating markers of endothelial dysfunction in people with type 1 diabetes without macrovascular disease or microalbuminuria

“…People with impaired glucose tolerance have been reported to have decreased CD34+ progenitor cell subtypes, but not reduced CD34+ VEGFR-2+ (EPC) cells, and post-glucose challenge glucose levels independently related to both CD34+ and CD34+ VEGFR-2+ levels [42], but in this group metabolic abnormalities would be more extensive and not restricted to hyperglycaemia.…”

Bone marrow-derived cells and the vasculature in diabetes: from biomarker to treatment?

“…However, putting these issues aside, the glucose status of all participants was characterised by fasting analysis and glucose tolerance test, and correlated with peripheral blood samples analysed for CD34 + / VEGFR2 + cell counts. The study showed that CD34 + and CD34 + /VEGFR2 + counts were negatively correlated with both fasting and post-challenge blood glucose [21]. In a previous study by the authors, diminution of the number of cells carrying the same surface markers correlated with peripheral vascular disease in diabetic individuals [24].…”

“…In this issue of Diabetologia, Fadini and colleagues make an association between circulating EPC numbers and glucose tolerance in non-diabetic individuals [21], extending previous data from the same authors on circulating EPC numbers in diabetes as a barometer of cardiovascular risk [22,23]. Recognising that glucose tolerance is a continuum between values in the normal range and in diabetes, the results are not necessarily surprising, yet they are important as we seek to identify and intervene earlier to help patients at risk of cardiovascular disease.…”