July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Diabetic Retinopathy Status as a Marker for More Severe Reduction in Circulating Endothelial Progentior Cells and Systemic Atherosclerosis in Diabetics
Author Affiliations & Notes
  • Kendrick Co Shih
    Department of Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
  • Ian Wong
    Department of Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
  • Jimmy SM Lai
    Department of Ophthalmology, University of Hong Kong, Hong Kong, Hong Kong
  • Kai Hang Yiu
    Department of Medicine, University of Hong Kong, Hong Kong Island, Hong Kong
  • Footnotes
    Commercial Relationships   Kendrick Shih, None; Ian Wong, None; Jimmy Lai, None; Kai Hang Yiu, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1043. doi:
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      Kendrick Co Shih, Ian Wong, Jimmy SM Lai, Kai Hang Yiu; Diabetic Retinopathy Status as a Marker for More Severe Reduction in Circulating Endothelial Progentior Cells and Systemic Atherosclerosis in Diabetics
      . Invest. Ophthalmol. Vis. Sci. 2018;59(9):1043.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Diabetes is associated with a reduction and dysfunction of circulating endothelial progenitor cells (EPC), which hastens the onset and progression of systemic atherosclerosis. We hypothesize that diabetic retinopathy status may serve as a marker for more severe depletion of circulating EPCs and thus systemic atherosclerosis.

Methods : We examined coronary calcifications by multidetector computed tomography, carotid intimal medial thickness and arterial segment pulse-wave velocities and their relationships with different subtypes of circulating EPC in 163 patients with type II diabetes (126 patients without retinopathy and 34 patients with retinopathy). Four subpopulations of EPC were determined by flow cytometry on the basis of surface expression of CD34, CD133, and KDR antigen: CD34+, CD34/KDR+, CD133+, and CD133/KDR+ EPC, respectively.

Results : The average of the subjects was 67.6 years, with an average BMI of 25.5. 45% of subjects were male. Subjects with diabetic retinopathy had on average longer duration of diabetes than those without (15 years vs 8 years).

All subjects had severely depleted levels of all circulating EPCs. Patients with diabetic retinopathy had significantly lower CD34/KDR+ (1.42% vs 1.70%) and CD34+ EPC counts (5.49% vs 6.55%) than those without. There were no significant differences between the groups in CD133+ and CD133/KDR+ counts. The mean Agatson score for coronary calcification was significantly higher in those with diabetic retinopathy compared to those without diabetic retinopathy (248.38 vs 143.57 , p =0.02). Furthermore, subjects with diabetic retinopathy had significantly higher carotid intimal medial thickness (0.91 mm vs 0.88 mm), heart-femoral PWV (976.68 vs 873.29) , heart-ankle PWV (1084 vs 1080) and brachial-ankle PWV (1815 vs 1782) those those without.

Conclusions : Our results demonstrated that the presence of diabetic retinopathy was associated with lower levels of circulating CD34+ and CD34/KDR+ EPCs, more severe carotid and coronary atherosclerosis as well as increased central and peripheral arterial stiffness. Thus, diabetic retinopathy status is a useful marker for severe depletion of circulating EPCs and systemic atherosclerosis.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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