Clinical and Biochemical Predictors of Endothelial Dysfunction in Egyptian Adolescents with Type 1 and those with Type 2 Diabetes

Abstract

Aims: Since endothelial dysfunction precedes clinically significant diabetic vascular complications, circulating endothelial progenitor cells (EPCs) have generated interest as a biomarker of endothelial function and are considered a mirror for endogenous vasculo-regenerative capacity. So we aimed to assess EPCs count in adolescents with type 1 diabetes mellitus (T1DM) in comparison to those with type 2 diabetes mellitus (T2DM) and extend these findings to assess their relationship to other clinical and biochemical risks of endothelial dysfunction. Patients and Methods: Fifty Egyptian adolescents were included in this study, 20 with T1DM, 20 T2DM and 10 healthy control subjects. Patients are recruited from Diabetes and Endocrinology Unit, outpatient clinic of internal medicine department Tanta University Hospital, in the period from 2017 to 2019. EPCs count was determined by Flowcytometry, anthropometric measurements and laboratory investigations were done for fasting and 2-hours post-prandial blood glucose, serum lipid profile, HbA1c, urinary albumin creatinine ratio, fasting C peptide, and homoeostasis model assessment of insulin resistance (HOMA- IR). Results: In T1DM, EPCs count was significantly higher compared to T2DM(0.032) and control group(p0.001) and it was negatively correlated with age of patients and duration of diabetes but was positively correlated with HbA1c. While, the count was higher in T2DM compared to control with no statistically significant difference(p0.063) and negatively correlated with body mass index, waist circumference, blood pressure and HOMA-IR. Conclusion: Adolescents with T2DM have distressing clinical and biochemical findings and significantly lower count of (EPCs) than adolescents with T1DM. This puts them at potential higher risk for early development of endothelial dysfunction and less power of vascular repair that may potentiate early harboring of vascular complications.