Endothelial progenitor cells in long-standing asymptomatic type 1 diabetic patients with or without diabetic nephropathy.
A decrease in the number and dysfunction of endothelial progenitor cells (EPC) may increase the risk for progression of cardiovascular disease (CVD) in type 1 diabetic patients with diabetic nephropathy (DN). Our aim was to evaluate EPC numbers in asymptomatic CVD type 1 diabetic patients with or without DN and to study the effect of CVD and medication on EPC numbers.


METHODS
We examined EPC numbers in 37 type 1 diabetic patients with DN and 35 type 1 diabetic patients with long-standing normoalbuminuria. Patients were without symptoms of CVD and the prevalence of CVD was previously shown to be very low. EPC number was assessed in in vitro cultures by fluorescent staining of attached cells.


RESULTS
There was no difference in EPC numbers between patients with DN (mean ± SD 120 ± 49 cells/field) and normoalbuminuria (108 ± 41 cells/field; p = 0.25). Furthermore, EPC number was not associated with CVD (p > 0.05). Conventional risk factors were significantly higher in patients with DN and they received more CVD-preventive treatment. All patients receiving simvastatin or calcium-channel blockers had higher numbers of EPC compared to patients not treated with these drugs.


CONCLUSIONS
Asymptomatic patients with DN had EPC numbers similar to normoalbuminuric patients, which was related to aggressive CVD intervention therapy. This may have contributed to the low prevalence of CVD.
Steno Diabetes Center, Gentofte, Denmark. hnri @ steno.dk
Henrik
H
Reinhard
Peter Karl
PK
Jacobsen
Maria
M
Lajer
Lise
L
Tarnow
Anne Sofie
AS
Astrup
Won Yong
WY
Kim
Nadja
N
Pedersen
Nils
N
Billestrup
Thomas
T
Mandrup-Poulsen
Hans-Henrik
HH
Parving
Peter
P
Rossing
D000328:Adult; D000924:Anticholesteremic Agents / Q000494:pharmacology; D002121:Calcium Channel Blockers / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000150:complications*; D002452:Cell Count; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D042783:Endothelial Cells / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D059630:Mesenchymal Stem Cells / Q000166:cytology* / Q000187:drug effects; D008875:Middle Aged; D012307:Risk Factors; D019821:Simvastatin / Q000494:pharmacology
D000924:Anticholesteremic Agents; D002121:Calcium Channel Blockers; D019821:Simvastatin