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. 2017 Sep 4;9(2):113-120.
doi: 10.1007/s13340-017-0335-x. eCollection 2018 May.

Impact of glycemic variability on the levels of endothelial progenitor cells in patients with type 1 diabetes

Yuiko Inaba  1 , Chiharu Tsutsumi  1 , Fumitaka Haseda  1 , Reiko Fujisawa  1 , Shinobu Mitsui  1 , Hiroyuki Sano  1 , Jungo Terasaki  1 , Toshiaki Hanafusa  1   2 , Akihisa Imagawa  1
Affiliations

Impact of glycemic variability on the levels of endothelial progenitor cells in patients with type 1 diabetes

Yuiko Inaba et al. Diabetol Int. .

Abstract

Objective: A reduction in endothelial progenitor cell (EPC) count is considered to correlate with cumulative cardiovascular risk factors including hyperglycemia. This study was conducted to elucidate the influence of glycemic variability on EPC count in patients with diabetes.

Methods: In study 1, we examined the number of EPCs in 57 patients with type 1 diabetes and 43 patients with type 2 diabetes. The number of EPCs (CD34+, CD34+CD133+, CD34+CD309+, and CD34+CD133+CD309+) was counted as the number of cells per 106 events. In study 2, we examined 37 outpatients with type 1 diabetes without macrovascular complications. We assessed associations between EPC count and seven parameters of glycemic variability (blood glucose standard deviation, mean amplitude of glycemic excursion, J index, M value, mean of daily differences, low blood glucose index, and high blood glucose index), as measured by continuous glucose monitoring. We further analyzed the correlation between EPC count and the carotid intima-media thickness (IMT) in 24 patients.

Results: In study 1, the number of circulating CD34+ and CD34+CD133+ cells was significantly decreased in patients with type 1 diabetes relative to that in patients with type 2 diabetes (p = 0.020 and 0.036, respectively). In study 2, a univariate analysis showed that the J index was negatively correlated with logCD34+ (r = -0.342, p = 0.039). LogCD34+ was significantly negatively associated with the max IMT (r = -0.486, p = 0.012) and the mean IMT (r = -0.503, p = 0.016).

Conclusions: An increase in the J index, which reflects both hyperglycemia and glycemic variability, is associated with a reduction in the EPC count, which might result in the progression of diabetic vascular complications.

Keywords: Continuous glucose monitoring; Endothelial progenitor cells; Glycated albumin; Glycemic variability; Intima-media thickness; J index; Type 1 diabetes.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.Informed consent or a substitute for it was obtained from all patients before they were included in the study.

Figures

Fig. 1
Fig. 1
Association between logCD34+ and the carotid IMT among 24 patients with type 1 diabetes. a Association between logCD34+ and the max IMT. b Association between logCD34+ and the mean IMT
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