Decreased circulating CD34+ cells are associated with progression of diabetic nephropathy.
OBJECTIVE
Circulating progenitor cells such as CD34+ cells play a key role in maintenance of vascular endothelial function and neovascularization, and a decrease in the number of CD34+ cells is associated with cardiovascular disease. However, the contribution of circulating progenitor cells to microvascular disease, such as diabetic nephropathy, is unclear. This study was therefore designed to clarify the association between diabetic nephropathy and circulating CD34+ cells.


METHODS
We measured circulating CD34+ cell numbers in 85 Type 2 diabetic patients aged 40-70 years with normo- and microalbuminuria and determined the association with urinary albumin excretion rate (UAER).


RESULTS
The number of circulating CD34+ cells significantly correlated with log UAER (r = -0.289, P = 0.008). Furthermore, in patients with low numbers of CD34+ cells (0.68 > cells/microl, lowest quartile of CD34+ cell number) UAER increased significantly after 12 months compared with baseline [from 34.3 +/- 7.0 to 53.6 +/- 10.8 mg/g creatinine (gCr), P < 0.05], whereas in patients with a high number of CD34+ cells (1.0 < cells/microl, highest quartile of CD34+ cell number) UAER did not change (from 16.7 +/- 4.8 to 20.1 +/- 3.0 mg/gCr).


CONCLUSIONS
These results suggest that a decreased number of circulating CD34+ cells is involved in the progression of diabetic nephropathy and may be a predictor of the disease.
Makino
H
H
Department of Atherosclerosis and Diabetes, National Cardiovascular Centre, Suita, Osaka, Japan. makinoh@hsp.ncvc.go.jp
Okada
S
S
Nagumo
A
A
Sugisawa
T
T
Miyamoto
Y
Y
Kishimoto
I
I
Kikuchi-Taura
A
A
Soma
T
T
Taguchi
A
A
Yoshimasa
Y
Y
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications*; D018952:Antigens, CD34 / Q000097:blood; D002452:Cell Count; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013234:Stem Cells / Q000378:metabolism
D018952:Antigens, CD34