Circulating endothelial cells are elevated in patients with type 1 diabetes mellitus.
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.
Asicioglu
Ebru
E
Division of Nephrology, Department of Internal Medicine, Marmara University School of Medicine, Tophanelioglu Caddesi, No 15/10, Altunizade, Uskudar, Istanbul 32622, Turkey.
Gogas Yavuz
Dilek
D
Koc
Mehmet
M
Ozben
Beste
B
Yazici
Dilek
D
Deyneli
Oguzhan
O
Akalin
Sema
S
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
D017392:Thiobarbituric Acid Reactive Substances; D043303:Aryldialkylphosphatase; D005978:Glutathione