Circulating Endothelial Progenitors Cells as A Marker for Vascular Complications in Diabetic Patients

Introduction: Knowing that the degree of hyperglycaemia correlates directly with the development of vascular morbidities and its role as a key of pathogenic factor in the development of endothelial dysfunction. Therefore a common approach for the prevention and treatment of diabetic complications relies on the understanding of the endothelial dysfunction pathophysiology. Aim of the Work: This study aimed to focus on the mechanism of Endothelial Progenitor cells (EPCs) reduction and dysfunction associated with diabetes discussing their role in virtually all diabetic complications. Materials and Methods: Twenty nine diabetic patients and ten normal healthy controls were included in the study after giving informed consent. Diabetic patients were (8) males and (21) females with mean age of (49.7±13.9) 9 cases (31%) were with macro vascular complications, 13 cases (45%) with microvascular complications and 7 cases (24%) were with no vascular complications 16 cases (65%) were with (type I) di ahetes and 13 cases ( 44%) were with type (II) diabetes mellitus, 11 cases (37%) were on oral hypoglycacmic medications and (18) cases (62%) were on insulin treatment. The mean duration of diabetes mellitus was (11.5±6.5) years (ranged from I year 25 ys duration) type II diabetes was defined according to American Diabetes association criteria (the expert committee on the diagnosis and classification of diabetes mellitus, 1997). All subjects were also subjected to routine laboratory investigations, fasting and post prandial blood glucose, glcosylatcd Hh (HbA1C) expression of endothelial marker CD133 which was determined by flow cytometric analysis of whole blood sample and culture of endothelial progenitor cells. Results: In the current study it was found that CD 133 was significantly lower in all diabetic patient groups than control group po=0.000. Regarding HbA !Cit was not correlated with CD133 p=0.1 and number of colonies in culture it was higher in macro and microvascular complication groups than control group p=0.04 and 0.000 respectively while there is no significant difference between nonvascular complication group and the control group p=0.06. Conclusions: This study conclude that circulating EPCS CD133 can he used as a marker for vascular complications in all diabetic patient and have a prominent role in pathogenesis of all diabetic complications groups (macro, micro, and no vascular complication groups) moreover HbA I C must he used as an independent marker of diabetes, and number of colonies in culture can be used as an indicator of activity of circulaung endothelial cells progenitor as diabetic hyperglycaemia is one of the stress condition.