title: Circulating endothelial cells are elevated in patients with type 1 diabetes mellitus.
abstract: OBJECTIVE
  Circulating endothelial cells (CECs) have emerged as vascular damage markers and are increased in type 2 diabetic patients. Since type 1 diabetes is associated with vascular damage, we hypothesized high CEC numbers in this patient population.
  
  
  METHODS
  Thirty-nine patients with type 1 diabetes and 39 controls were included. CECs were isolated using anti-CD146-coated Dynabeads, stained with Ulex lectin-1, and counted by fluorescence microscopy. Endothelial function was measured as flow-mediated dilation (FMD). Thiobarbituric acid reactive substances (TBARS), total glutathione levels (GSH), and paraoxonase (PON) activity levels were measured as oxidative stress markers.
  
  
  RESULTS
  Patients with type 1 diabetes mellitus had higher number of CECs (7.46+/-5.37 vs 2.13+/-1.13 cells/ml, P<0.001), lower FMD (7.87+/-2.19 vs 12.06+/-2.34%, P<0.001), higher TBARS (4.94+/-1.20 vs 3.07+/-0.75 nmol/MDA, P<0.001), lower GSH (206.12+/-98.06 vs 353.61+/-68.45 microM, P<0.001), and lower PON activity levels (89.10+/-17.82 vs 127.65+/-29.01 U/l, P<0.001) as compared to controls. There was positive correlation between CEC numbers and HbAlc levels (r=0.49, P=0.002). CECs and fasting glucose levels were not correlated. There was no correlation between the number of CECs and FMD. Furthermore, there were no correlations between the number of CECs and TBARS, GSH and PON activity levels. Multiple regression analysis showed that HbAlc levels (r(2)=0.40, P<0.009) were associated with CEC numbers.
  
  
  CONCLUSIONS
  CECs are elevated in patients with type 1 diabetes mellitus reflecting endothelial damage. This increase is dependent on long-term glucose control.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Tophanelioglu Caddesi, No 15/10, Altunizade, Uskudar, Istanbul 32622, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Asicioglu
authors.forename: Dilek
authors.initials: D
authors.lastname: Gogas Yavuz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Koc
authors.forename: Beste
authors.initials: B
authors.lastname: Ozben
authors.forename: Dilek
authors.initials: D
authors.lastname: Yazici
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Deyneli
authors.forename: Sema
authors.initials: S
authors.lastname: Akalin
mesh_terms: D000328:Adult; D043303:Aryldialkylphosphatase / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002452:Cell Count; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D008297:Male; D008856:Microscopy, Fluorescence; D018384:Oxidative Stress / Q000276:immunology*; D018709:Statistics, Nonparametric; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014463:Ultrasonography; D014664:Vasodilation
chemical_list: D017392:Thiobarbituric Acid Reactive Substances; D043303:Aryldialkylphosphatase; D005978:Glutathione