title: Relationship between circulating endothelial progenitor cells and endothelial dysfunction in children with type 1 diabetes: a novel paradigm of early atherosclerosis in high-risk young patients.
abstract: OBJECTIVE
  The low number of circulating endothelial progenitor cells (EPCs) has emerged as a biomarker of cardiovascular (CV) risk in adults. Data regarding EPCs in paediatric populations with CV risk factors are limited. The aim of the study was to estimate the EPC number and its relationship with vascular function and structure in children with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  We performed a comparative analysis of 52 children with T1DM (mean age 14.5 years; diabetes duration, 6.0 years; HbA1c level, 8.5%) and 36 healthy age- and gender-matched control children. EPCs were identified and analysed by flow cytometry with the use of MABs directed against CD34, CD144 (VE-cadherin) and CD309 (VEGFR-2). sICAM-1, hsCRP, thrombomodulin and adiponectin levels were also assessed. We evaluated vascular function (flow-mediated dilation (FMD)) and structure (carotid intima-media thickness (IMT)) ultrasonographically.
  
  
  RESULTS
  Frequencies of CD34+ cells were similar in both groups (P=0.30). In contrast, frequencies of CD34+VE-cadherin+ cells were significantly higher in diabetic children compared with the healthy group (P=0.003). Similarly, diabetic patients tended to present with higher frequencies of CD34+VEGFR+ cells (P=0.06). FMD was lower (6.9 vs 10.5%, P=0.002) and IMT was higher (0.50 vs 0.44 mm, P=0.0006) in diabetic children. We demonstrated a significant relationship between CD34+VEGFR-2+ cells and BMI (r=0.3, P=0.014), HDL (r=-0.27, P=0.04), sICAM-1 (r=0.47, P=0.023) and FMD (r=-0.45, P<0.001). Similarly, frequencies of CD34+VE-cadherin+ cells were significantly correlated with BMI (r=0.32, P=0.02) and FMD (r=-0.31, P=0.03).
  
  
  CONCLUSIONS
  We demonstrated here that increased frequencies of EPCs observed in diabetic children are negatively correlated with endothelial function. Further studies are warranted to assess whether this phenomenon might result from effective mobilisation of EPCs in order to repair damaged endothelium in children at increased risk for atherosclerosis.
authors.affiliation: Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Waszyngtona Street 17, 15-274 Białystok, Poland. bglowinska@poczta.onet.pl
authors.forename: Barbara
authors.initials: B
authors.lastname: Głowińska-Olszewska
authors.forename: Marcin
authors.initials: M
authors.lastname: Moniuszko
authors.forename: Andrzej
authors.initials: A
authors.lastname: Hryniewicz
authors.forename: Marta
authors.initials: M
authors.lastname: Jeznach
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Rusak
authors.forename: Milena
authors.initials: M
authors.lastname: Dąbrowska
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Łuczyński
authors.forename: Anna
authors.initials: A
authors.lastname: Bodzenta-Łukaszyk
authors.forename: Artur
authors.initials: A
authors.lastname: Bossowski
mesh_terms: D000293:Adolescent; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D015820:Cadherins / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D013234:Stem Cells / Q000378:metabolism / Q000473:pathology*; D000099152:Cadherin 5
chemical_list: D015703:Antigens, CD; D018952:Antigens, CD34; D015820:Cadherins; D000099152:Cadherin 5