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. 2013 Jun;36(6):1647-53.
doi: 10.2337/dc12-1206. Epub 2013 Jan 22.

Endothelial progenitor cells are related to glycemic control in children with type 1 diabetes over time

Thomas Hörtenhuber  1 , Birgit Rami-Mehar, Miriam Satler, Katrin Nagl, Clemens Höbaus, Florian Höllerl, Renate Koppensteiner, Guntram Schernthaner, Edith Schober, Gerit-Holger Schernthaner
Affiliations

Endothelial progenitor cells are related to glycemic control in children with type 1 diabetes over time

Thomas Hörtenhuber et al. Diabetes Care. 2013 Jun.

Abstract

Objective: The risk of cardiovascular death before the age of 40 is 20-fold higher in patients with type 1 diabetes mellitus (T1DM). Endothelial progenitor cells (EPCs) predict cardiovascular morbidity and mortality in patients without diabetes. We hypothesized that EPCs are modified in children with T1DM and are related to characteristics of T1DM such as glycemic control.

Research design and methods: Children (n = 190; 156 T1DM subjects and 34 control subjects) were included in an observational cohort study and matched for age and sex. EPCs were enumerated by flow cytometry at the beginning (cross-sectional) and 1 year later (longitudinal). To analyze changes of variables during the observation, Δ values were calculated.

Results: EPCs were significantly reduced in T1DM children versus control subjects (609 ± 359 vs. 1,165 ± 484, P < 0.001). Multivariate regression modeling revealed that glycated hemoglobin A1c (HbA1c) was the strongest independent predictor of EPCs (β = -0.355, P < 0.001). Overall glycemic control at the beginning and end of study did not differ (7.8 ± 1.2 vs. 7.8 ± 1.2 relative %, P = NS), but we observed individual HbA1c changes of -4.30/+3.10 relative %. The strongest EPC increase was observed in the patients with the most favorable HbA1c lowering during the 1-year follow-up. Accordingly, the strongest EPC decrease was demonstrated in the patients with the strongest HbA1c worsening during the time period.

Conclusions: This is the first prospective study demonstrating diminished EPCs in children with T1DM. The association of better glycemic control with an increase in EPC numbers within 1 year suggests that a reduction of the high cardiovascular disease burden might be mediated likewise.

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Figures

Figure 1
Figure 1
CPCs and EPCs in patients with T1DM. CO, control subjects. An α level of P < 0.05 (two-tailed) is considered statistically significant.
Figure 2
Figure 2
Association of all EPC data with all HbA1c data. An α level of P < 0.05 (two-tailed) is considered statistically significant. Middle line is line of fit. The two additional lines are 95% CIs.
Figure 3
Figure 3
Association of ΔEPCs with ΔHbA1c. An α level of P < 0.05 (two-tailed) is considered statistically significant. Middle line is line of fit. The two additional lines are 95% CIs.
See this image and copyright information in PMC

References

    1. Pambianco G, Costacou T, Ellis D, Becker DJ, Klein R, Orchard TJ. The 30-year natural history of type 1 diabetes complications: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes 2006;55:1463–1469 - PubMed
    1. Soedamah-Muthu SS, Fuller JH, Mulnier HE, et al. High risk of cardiovascular disease in patients with type 1 diabetes in the U.K.: a cohort study using the general practice research database. Diabetes Care 2006;29:798–804 - PubMed
    1. Waernbaum I, Blohmé G, Ostman J, et al. Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden. Diabetologia 2006;49:653–659 - PubMed
    1. Skrivarhaug T, Bangstad HJ, Stene LC, Sandvik L, Hanssen KF, Joner G. Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway. Diabetologia 2006;49:298–305 - PubMed
    1. Laing SP, Swerdlow AJ, Slater SD, et al. Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes. Diabetologia 2003;46:760–765 - PubMed

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