Abstract 15404: Relation Between EPC and Atherosclerosis in Severe Obesity: the Detrimental Modulating Effect of Diabetes
Purpose: Endothelial Progenitor Cells (EPCs) contribute to angiogenesis and tissue repair and their circulating levels are inversely correlated with vascular function. Adipose tissue represents a significant source of EPCs and recently morbid obesity has been shown to be associated to EPC mobilization and preserved vascular function. However diabetes has negative effects on EPCs levels, but little is known about the role of fat tissue per se on EPC mobilization in the presence of diabetes. To this aim we assessed EPCs levels in morbidly obese (MO) individuals with and without diabetes and their correlation with intima-media thickness (IMT) and anthropometric parameters.
Methods: We studied 100 MO subjects (BMI= 47.4±7.3 kg/m2, age 44±10.4, 43 males) without cardiovascular disease; 35 were diabetic (MOD: BMI= 46.3±6.3 kg/m2,age 48.2±9.4, 16 males) and 65 non diabetic (MOND: BMI= 48±6.8 kg/m2,age 41.7±10.3, 27 males). Anthropometric measures of extent of fat tissue (weight, BMI, waist circumference), and of atherosclerosis [IMT by ultrasonography and circulating EPCs (defined by flow-cytometry as KDR+/CD34+/CD45-cells)], were assessed.
Results: EPCs were directly correlated with weight (r= 0.24 p= 0.015), BMI (r= 0.24 p= 0.016) and waist circumference (r=0.26 p= 0.023) while a negative correlation was found with IMT (r= -0.23, p=0.024). When diabetics and non-diabetics were considered separately, these correlations were no longer found in MOD [weight (r= 0.034 p= 0.85), BMI (r=0.034 p= 0.85), waist circumference (r= 0.074 p= 0.70), IMT (r= 0.054, p=0.76)] while they were confirmed in MOND [weight (r= 0.27 p= 0.027), BMI (r=0.29 p= 0.019), waist circumference (r= 0.30 p= 0.041), IMT (r= -0.30, p= 0.016)].
Conclusions: Our study demonstrates that in MO circulating EPCs are directly correlated to the amount of fat measured by anthropometric parameters and are negatively correlated with IMT, possibly explaining the paradoxical preservation of vascular function observed in morbid obesity. However, these correlation disappear when diabetes intervenes suggesting that diabetes per se represents a strong adverse condition, able to abolish the potential protective role of adipose tissue and mightrepresent a novel mechanism of diabetic vascular disease.
- © 2011 by American Heart Association, Inc.