Relations among glycemic control, circulating endothelial cells, nitric oxide, and flow mediated dilation in patients with type 2 diabetes mellitus.
OBJECTIVE
Circulating endothelial cells (CEC) have been identified as a surrogate marker of endothelial dysfunction. The aim of this study was to determine the association of glycemic control with CEC and endothelial function in patients with type 2 diabetes mellitus (DM).


METHODS
We studied 30 patients with type 2 DM and 20 age and sex matched healthy controls (HC). Number of circulating endothelial cells was measured by flow cytometry. Endothelial function was studied by measuring flow mediated vasodilation (FMD%) in the brachial artery and serum level of nitric oxide (NO).


RESULTS
CEC count was significantly elevated in patients with DM, than HC (35.3±15.1 vs. 7.3±2.4, p<0.001) and in patients with HbA1c>7 than patients with HbA1c≤7 (47.4±5.5 vs. 19.5±5.7, p<0.001). FMD% and NO were lower in DM patients than HC (3.5±0.85 vs. 9.5±3.1, p<0.001 and 37.8±6.1 vs. 64.1±5.7, p<0.001 respectively). FMD% and NO were lower in patients with HbA1c>7 as compared to patients with HA1c≤7 (2.8±0.4 vs. 4.3±0.4, p<0.001 and 33.1±2.9 vs. 43.9±2.8, respectively, p<0.001). HbA1c correlated negatively with FMD% and NO levels and positively with CEC. CEC count correlated negatively with FMD% and NO. There was a significant positive correlation between CEC count and HBA1c (p<0.001 for all correlations).


CONCLUSIONS
CEC is associated with markers of endothelial dysfunction and disease control in patients with type 2 DM. These findings suggest a potential role of CEC in the pathophysiology of cardiovascular disease in type 2 diabetic and raise the importance of tight glycemic control.
Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
N A
NA
Kotb
R
R
Gaber
W
W
Salah
A
A
Elhendy
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D051929:CD146 Antigen / Q000097:blood / Q000378:metabolism; D055252:Cell-Derived Microparticles / Q000378:metabolism / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005434:Flow Cytometry; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D014463:Ultrasonography; D014664:Vasodilation
D015415:Biomarkers; D051929:CD146 Antigen; D006442:Glycated Hemoglobin; D009569:Nitric Oxide; C497902:MCAM protein, human; C517652:hemoglobin A1c protein, human