Multifactorial treatment increases endothelial progenitor cells in patients with type 2 diabetes

TY - JOUR

T1 - Multifactorial treatment increases endothelial progenitor cells in patients with type 2 diabetes

AU - Reinhard, H

AU - Jacobsen, P Karl

AU - Lajer, Marianne

AU - Pedersen, N

AU - Billestrup, N

AU - Mandrup-Poulsen, Thomas

AU - Parving, H-H

AU - Rossing, P

PY - 2010/10/1

Y1 - 2010/10/1

N2 - Aims/hypothesis Endothelial progenitor cells (EPC) augment vascular repair and neovascularisation. Patients with type 2 diabetes have reduced EPC and increased risk of cardiovascular disease (CVD), which is reduced by multifactorial intervention. Our aim, therefore, was to evaluate in type 2 diabetic patients whether the numbers of EPC derived from peripheral blood mononuclear cells is influenced by a multifactorial treatment strategy. Methods We enrolled 28 patients newly referred for initiation of multifactorial treatment, which consisted of improving glycaemic, lipid and blood pressure control, as well as antithrombotic therapy and lifestyle modification. EPC count was assessed by in vitro cultures at baseline and after 90 days of treatment. After 7 days in culture, we identified EPC by fluorescent staining of attached cells. Patients were treated with metformin, aspirin, statins and angiotensin II receptor blockers, and divided accordingly into groups of mono-, dual-, triple- or quadruple therapy. Results After 90 days of treatment, glycaemic control improved and total cholesterol decreased. Multifactorial intervention for 90 days significantly increased EPC count in cultures by 35% (from 105 [SE 8] to 140 [11] cells per field [p=0.002]). The change in EPC among patients with quadruple therapy was higher (63%) than in untreated patients (-32%, p=0.043). Conclusions/interpretation Numbers of EPC derived from peripheral blood mononuclear cells increased significantly after multifactorial intervention in type 2 diabetic patients. It remains to be shown whether these changes contribute to the beneficial effects of multifactorial intervention on diabetic micro- and macroangiopathy.

AB - Aims/hypothesis Endothelial progenitor cells (EPC) augment vascular repair and neovascularisation. Patients with type 2 diabetes have reduced EPC and increased risk of cardiovascular disease (CVD), which is reduced by multifactorial intervention. Our aim, therefore, was to evaluate in type 2 diabetic patients whether the numbers of EPC derived from peripheral blood mononuclear cells is influenced by a multifactorial treatment strategy. Methods We enrolled 28 patients newly referred for initiation of multifactorial treatment, which consisted of improving glycaemic, lipid and blood pressure control, as well as antithrombotic therapy and lifestyle modification. EPC count was assessed by in vitro cultures at baseline and after 90 days of treatment. After 7 days in culture, we identified EPC by fluorescent staining of attached cells. Patients were treated with metformin, aspirin, statins and angiotensin II receptor blockers, and divided accordingly into groups of mono-, dual-, triple- or quadruple therapy. Results After 90 days of treatment, glycaemic control improved and total cholesterol decreased. Multifactorial intervention for 90 days significantly increased EPC count in cultures by 35% (from 105 [SE 8] to 140 [11] cells per field [p=0.002]). The change in EPC among patients with quadruple therapy was higher (63%) than in untreated patients (-32%, p=0.043). Conclusions/interpretation Numbers of EPC derived from peripheral blood mononuclear cells increased significantly after multifactorial intervention in type 2 diabetic patients. It remains to be shown whether these changes contribute to the beneficial effects of multifactorial intervention on diabetic micro- and macroangiopathy.

KW - Angiotensin Receptor Antagonists

KW - Aspirin

KW - Cell Count

KW - Cells, Cultured

KW - Diabetes Mellitus, Type 2

KW - Diet, Reducing

KW - Endothelial Cells

KW - Exercise Therapy

KW - Female

KW - Humans

KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors

KW - Leukocytes, Mononuclear

KW - Life Style

KW - Male

KW - Metformin

KW - Stem Cells

KW - Treatment Outcome

U2 - 10.1007/s00125-010-1843-4

DO - 10.1007/s00125-010-1843-4

M3 - Journal article

C2 - 20607514

SN - 0012-186X

VL - 53

SP - 2129

EP - 2133

JO - Diabetologia

JF - Diabetologia

IS - 10

ER -