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Complications impaired endothelial progenitor cell function in Type 2 diabetic patients with or without critical leg ischaemia: implication for impaired neovascularization in diabetes
Author(s) -
Chen M.C.,
Sheu J.J.,
Wang P.W.,
Chen C.Y.,
Kuo M.C.,
Hsieh C.J.,
Chen J.F.,
Chang H.W.
Publication year - 2009
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2008.02649.x
Subject(s) - interquartile range , medicine , diabetes mellitus , critical limb ischemia , ischemia , vascular disease , progenitor cell , cardiology , surgery , endocrinology , arterial disease , stem cell , biology , genetics
Aims This study tested the hypothesis that migratory function of endothelial progenitor cells (EPCs) is impaired in Type 2 diabetic patients with or without critical leg ischaemia. Methods Seventy‐four patients were classified into four groups: Type 2 diabetic ( n = 21) and non‐diabetic patients ( n = 10) with critical leg ischaemia and Type 2 diabetic patients without lower extremity vascular disease ( n = 30) and healthy subjects ( n = 13). The number and functional activity of circulating and cultured EPCs were determined. Results The migratory function of cultured EPCs was significantly impaired in diabetic patients without (median, 48, interquartile range, 46, 49 count/view/well) and with (median, 51, interquartile range, 46, 60 count/view/well) critical leg ischaemia and non‐diabetic patients with critical leg ischaemia (median, 49, interquartile range, 47, 55 count/view/well) compared with healthy subjects (median, 63, interquartile range, 57, 65 count/view/well) ( P < 0.0001). The number of circulating EPCs was lower in Type 2 diabetic patients without lower extremity vascular disease (median, 3500, interquartile range, 1600, 6600/10 6 cytometric events) than Type 2 diabetic patients with critical leg ischaemia (median, 5300, interquartile range, 2400, 11 100/10 6 cytometric events), non‐diabetic patients with critical leg ischaemia (median, 5550, interquartile range, 2000, 32 100/10 6 cytometric events) and healthy subjects (median, 5400, interquartile range, 2700, 8700/10 6 cytometric events) ( P = 0.413). Conclusions The migratory function of EPCs is impaired in patients with Type 2 diabetes, even in those without critical leg ischaemia. These findings present an important new insight into the pathogenesis of impaired neovascularization and critical limb ischaemia in diabetic patients and provide avenues of future clinical study.