Low CD34+ cell count and metabolic syndrome synergistically increase the risk of adverse outcomes

• Published in: Atherosclerosis Vol. 207; no. 1; pp. 213 - 219
• Main Authors: Fadini, Gian Paolo, de Kreutzenberg, Saula, Agostini, Carlo, Boscaro, Elisa, Tiengo, Antonio, Dimmeler, Stefanie, Avogaro, Angelo
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.11.2009; Elsevier
• Subjects: AC133 Antigen; Antigens, CD - blood; Antigens, CD34 - blood; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Blood. Blood coagulation. Reticuloendothelial system; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - immunology; Cardiovascular Diseases - mortality; Cardiovascular risk; Case-Control Studies; Cell Count; Disease Progression; Endothelium; Female; Flow Cytometry; Follow-Up Studies; Glycoproteins - blood; Humans; Male; Medical sciences; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - immunology; Metabolic Syndrome - mortality; Middle Aged; Peptides - blood; Pharmacology. Drug treatments; Phenotype; Predictive Value of Tests; Proportional Hazards Models; Risk Assessment; Risk Factors; ROC Curve; Stem cells; Stem Cells - immunology; Time Factors; Vascular Endothelial Growth Factor Receptor-2 - blood; Metabolic syndrome; Stem cells; Cardiovascular risk; Endothelium; Endocrinopathy; Vascular disease; Prognosis; Stem cell; Atherosclerosis; Risk factor; Metabolic diseases; Cardiovascular disease
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.03.040

Metabolic syndrome (MetS) associates with endothelial dysfunction and a high risk of cardiovascular events and death. Circulating progenitor cells have been shown to contribute to endothelial homeostasis and repair . We aimed to test whether progenitor cell count is an independent event predictor and modifies cardiovascular risk associated with MetS. On the basis of the expression of CD34, CD133 and KDR, 6 phenotypes of progenitor cells were counted using flow cytometry in 214 subjects with and without MetS. We recorded classical risk factors and MetS components, cumulative risk estimates, and high-sensitive C-reactive protein. Subjects were followed-up for a median of 34 months to collect total events, cardiovascular events and all-cause mortality. In the Cox proportional hazards regression analyses, we found that, unlike other phenotypes, reduced CD34+ cells predicted cardiovascular and total events and death, independently of all potential confounders. Remarkably, a low CD34+ cell count significantly increased the risk associated with MetS, as shown by synergy indexes. The level of circulating CD34+ cells is a novel independent risk biomarker and modulates outcomes in the MetS, suggesting that generic progenitor cells have a role in disease development or progression over the long-term.