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- W2908103672 abstract "Objective. We evaluated the ability of circulating stem cell levels to predict future micro and macrovascular complications in patients with type 2 diabetes. We further investigate the prognostic value of stem cells in a wide and heterogeneous cohort of patients, using a meta-analytic approach. Research design and methods. A cohort of 187 patients with type 2 diabetes was followed-up for a median of 3.3 years and 6.1 years for the evaluation of microvascular and macrovascular outcomes, respectively. The primary outcomes were onset or progression of any microangiopathy, and time to a first cardiovascular event. In addition, we meta-analysed all studies reporting the prognostic role of the CPC/EPC measure on cardiovascular outcomes and death in a heterogeneous population of 4451 patients at high cardiovascular risk.Results. New onset or progression of microangiopathy occurred in 70 patients (9.5% per year). After controlling the false discovery rate (FDR), 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+KDR+ EPC levels below median were more likely to experience worsening microangiopathy than those with high cell levels. In FDR-fully-adjusted analysis, CD34+ cells predicted onset/progression of microalbuminuria, retinopathy, and any microangiopathy. A first cardiovascular event occurred in 48 patients (4.5% per year). Patients with incident cardiovascular events had significantly lower CD34+ and CD34+CD133+ cells than those without. Patients with below median levels of CD34+ and CD34+CD133+ cells experienced higher rates of cardiovascular events. In Cox proportional hazard regression analyses, a reduced CD34+ and CD34+CD133+ cell count independently predicted future events. Addition of the CD34+ cell count to the UKPDS risk engine model improved C-statistics, continuous NRI and/or IDI. In the meta-analysis, reduced CPC/EPC levels were associated with a ~2 fold increased risk of future cardiovascular events and cardiovascular death and the most predictive phenotypes were CD34+ and CD34+CD133+.Conclusions. In patients with type 2 diabetes, a reduced baseline level of circulating CD34+ stem cells predicts worsening of microangiopathy and cardiovascular events up to 6 years later, and improves risk stratification. The meta-analysis suggests that prognostic impact of reduced stem cell levels was similar in diabetic and non-diabetic patients." @default.
- W2908103672 created "2019-01-11" @default.
- W2908103672 creator A5030061168 @default.
- W2908103672 date "2018-01-05" @default.
- W2908103672 modified "2023-09-27" @default.
- W2908103672 title "CIRCULATING PROGENITOR CELLS: A NOVEL BIOMARKER OF MICROVASCULAR AND MACROVASCULAR DISEASE IN TYPE 2 DIABETIC PATIENTS" @default.
- W2908103672 hasPublicationYear "2018" @default.
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