Endocrine Abstracts

Introduction: Endothelial progenitor cells (EPCs) seems to be reduced in patients with diabetes mellitus, however it is unknown whether treatment with ACE-I may modify the number of EPCs. Therefore, the purpose of this study was to investigate if the administration of perindopril in diabetic patients with and without coronary artery disease can modify the number of circulating EPCs and alter their inflammatory state and endothelial function.

Methods: Twenty five diabetic patients were recruited and perindopril was administered to all patients for a one-month period. In parallel, ten non-diabetic control subjects were treated with placebo. In both groups blood sample were drawn on admission (baseline) and after one month of drug’s administration. CRP, vascular endothelial growth factor (VEGF) and asymmetric dimethylarginine (ADMA) were measured by standard techniques. Circulating EPCs were defined by the surface markers CD34+ (CD34 expressing cells) and analyzed by flow-cytometry. Moreover the endothelial function was evaluated both on admission and after treatment using the technique of flow mediated dilation (FMD).

Results: The number of circulating EPCs was compared between the groups of diabetic patients and control patients there was no significant difference in their variation (P>0.05). In the group of diabetic patients, no significant difference was observed in the number of endothelial progenitor cells before and after the administration of perindopril (3.72±1.98 vs 4.02±2.03, P=NS), either in plasma concentrations of CRP (2.472±2.74 vs 1.782±1.99, P=NS), VEGF (126.36±99.79 vs 163.19±121.52, P=NS) or in endothelial function (0.368±0.073 vs 0.388±0.073, P=NS). Nevertheless, the plasma concentration of ADMA in the group of diabetics showed a significant increase after the administration of perindopril (1.473±0.899 vs 0.939±0.883, P<0.05).

Conclusions: Administration of perindopril seems to increase plasma levels of ADMA. However, no significant difference in the number of circulating endothelial cells, CRP and VEGF plasma concentrations and endothelial function before and after the administration of perindopril was observed.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.