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Fadini GP, Bonora BM, Marcuzzo G, Marescotti MC, Cappellari R, Pantano G, Sanzari MC, Duran X, Vendrell J, Plebani M, Avogaro A. Circulating Stem Cells Associate With Adiposity and Future Metabolic Deterioration in Healthy Subjects. J Clin Endocrinol Metab 2015; 100:4570-8. [PMID: 26469382 DOI: 10.1210/jc.2015-2867] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Obesity and metabolic syndrome are associated with mild leukocytosis, but whether hematopoietic stem/progenitor cells (HSPCs) play a role in metabolic deterioration is unknown. OBJECTIVE Our objective was to analyze the cross-sectional and longitudinal associations between CD34(+) HSPCs, adiposity, and metabolic syndrome features. DESIGN This is a cross-sectional study on 242 participants, 155 of whom were followed and included in a longitudinal assessment. SETTING This study took place in a tertiary referral center for metabolic diseases. PARTICIPANTS Healthy working individuals attending a cardiovascular screening program (total n = 3158) and having a baseline measure of circulating CD34(+) cells participated. MAIN OUTCOME MEASURES We collected demographic and anthropometric data, cardiovascular risk factors, and metabolic syndrome parameters. RESULTS Participants (34.7% males, mean age 45.9 ± 0.5 years) were free from diabetes and cardiovascular disease. Cross-sectionally, absolute CD34(+) cell counts were directly correlated with body mass index and waist circumference, inversely correlated with high-density lipoprotein cholesterol and the quantitative insulin sensitivity check index, and were higher in individuals with the metabolic syndrome. The hematopoietic component contributed most to the association of CD34(+) cells with adiposity. During a 6.3-year follow-up, high absolute levels of CD34(+) cells were associated with increasing waist circumference, declining quantitative insulin sensitivity check index and high-density lipoprotein cholesterol, and with incidence of metabolic syndrome. Relative CD34(+) cell counts showed weaker associations with metabolic parameters than absolute levels, but were longitudinally associated with increasing waist circumference and metabolic syndrome development. CONCLUSIONS A mild elevation of circulating CD34(+) progenitor cells, reflecting expansion of HSPCs, is associated with adiposity and future metabolic deterioration in healthy individuals.
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Affiliation(s)
- Gian Paolo Fadini
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Benedetta Maria Bonora
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Giorgio Marcuzzo
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Maria Cristina Marescotti
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Roberta Cappellari
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Giorgia Pantano
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Maria Colomba Sanzari
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Xavier Duran
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Joan Vendrell
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Mario Plebani
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
| | - Angelo Avogaro
- Department of Medicine (G.P.F., B.M.B., M.C.M., R.C., G.P., M.C.S., M.P., A.A.), University of Padova, 35128 Padova, Italy; Venetian Institute of Molecular Medicine (G.P.F., X.D., A.A.), 35128 Padova, Italy; Department of Cardiologic, Thoracic and Vascular Sciences (G.M.), Service of Preventive Medicine, University of Padova, 35128 Padova, Italy; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) (X.D., J.V.), Instituto de Salud Carlos III, Madrid, Spain; Joan XXIII University Hospital (J.V.), Rovira i Virgili University IISPV, Tarragona, Spain
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Rigato M, Bittante C, Albiero M, Avogaro A, Fadini GP. Circulating Progenitor Cell Count Predicts Microvascular Outcomes in Type 2 Diabetic Patients. J Clin Endocrinol Metab 2015; 100:2666-72. [PMID: 25942480 DOI: 10.1210/jc.2015-1687] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Diabetes reduces the levels of circulating progenitor cells (CPCs) and endothelial progenitor cells (EPCs), which promote vascular repair and are inversely correlated with cardiovascular risk. OBJECTIVE The objective of the study was to test whether CPC/EPC levels predict onset/progression of microangiopathy in a cohort of type 2 diabetic (T2D) patients. DESIGN This was a pseudoprospective study with a 3.9-year follow-up. SETTING The study was conducted at a tertial referral diabetes outpatient clinic. PATIENTS A total of 187 T2D patients having a baseline determination of CPCs/EPCs participated in the study. INTERVENTION Baseline data on demographics, anthropometrics, concomitant risk factors, diabetic complications, and medications were collected. MAIN OUTCOME MEASURE Onset or progression of microangiopathy was assessed at follow-up compared with baseline. RESULTS New onset or progression of microalbuminuria, chronic kidney disease, retinopathy, and neuropathy occurred in 70 patients (9.5%/y). After controlling the false discovery rate, baseline CD34(+) CPCs and EPCs were significantly lower in patients with onset/progression of microalbuminuria and any microangiopathy. Patients with baseline CD34(+) CPC or CD133(+)/kinase insert domain-containing receptor(+)/EPC levels below the median were more likely to experience worsening microangiopathy than those with high cell levels. Independently from confounders, including age, sex, glycated hemoglobin, and diabetes duration, CD34(+) cells predicted onset/progression of microalbuminuria, retinopathy, and any microangiopathy in false discovery rate-adjusted analyses. A low CD34(+) cell count limited the beneficial effects of renin-angiotensin system blockers on microalbuminuria progression. CONCLUSIONS Levels of circulating (endothelial) progenitor cells predict microvascular outcomes in T2D. Together with previous studies showing an association with cardiovascular events, these data indicate that CPCs/EPCs represent biomarkers of the global complication burden in diabetes.
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Affiliation(s)
- Mauro Rigato
- Division of Metabolic Diseases, Department of Medicine (M.R., C.B., M.A., A.A., G.P.F.), University of Padova, 35128 Padova, Italy; and Venetian Institute of Molecular Medicine (A.A., G.P.F.), 35128 Padova, Italy
| | - Cristina Bittante
- Division of Metabolic Diseases, Department of Medicine (M.R., C.B., M.A., A.A., G.P.F.), University of Padova, 35128 Padova, Italy; and Venetian Institute of Molecular Medicine (A.A., G.P.F.), 35128 Padova, Italy
| | - Mattia Albiero
- Division of Metabolic Diseases, Department of Medicine (M.R., C.B., M.A., A.A., G.P.F.), University of Padova, 35128 Padova, Italy; and Venetian Institute of Molecular Medicine (A.A., G.P.F.), 35128 Padova, Italy
| | - Angelo Avogaro
- Division of Metabolic Diseases, Department of Medicine (M.R., C.B., M.A., A.A., G.P.F.), University of Padova, 35128 Padova, Italy; and Venetian Institute of Molecular Medicine (A.A., G.P.F.), 35128 Padova, Italy
| | - Gian Paolo Fadini
- Division of Metabolic Diseases, Department of Medicine (M.R., C.B., M.A., A.A., G.P.F.), University of Padova, 35128 Padova, Italy; and Venetian Institute of Molecular Medicine (A.A., G.P.F.), 35128 Padova, Italy
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