European Heart Journal Advance Access originally published online on May 30, 2008
European Heart Journal 2008 29(12):1560-1568; doi:10.1093/eurheartj/ehn213
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Decreased number of circulating progenitor cells in obesity: beneficial effects of weight reduction
1 Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
2 Department of Clinical Chemistry, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
3 Department of Hematology and Oncology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
4 Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
Received 9 July 2007; revised 6 April 2008; accepted 6 May 2008; online publish-ahead-of-print 30 May 2008.
* Corresponding author. Tel: +49 221 478 32544, Fax: +49 221 478 32397, Email: markus.flesch{at}uni-koeln.de or muller.ehmsen{at}uni-koeln.de
Aims: Cardiovascular risk factors are associated with decreased levels of circulating progenitor cells (CPC). The aim of this study was to determine whether the number of CPC is an independent correlate of body mass index (BMI) and whether weight loss leads to an increase in CPC.
Methods and results: CD34 positive and KDR/CD34, CD133/CD34, and CD117/CD34 double positive cells were measured by fluorescence activated cell sorting (FACS) analysis in peripheral blood of 149 volunteers (52.5 ± 12.0 years, BMI 21.5–52.7 kg/m2, mean 31.6 ± 5.1 kg/m2) participating in a weight reduction program offered by German pharmacies. In addition, carotid intima media thickness (IMT) and brachial artery flow-mediated dilatation were determined. After a diet and sports program for 6 months, 86 representing subjects were re-evaluated (mean weight loss 5.8 ± 5.2 kg). There was an inverse correlation between BMI as well as waist circumference and CPC, especially CD34 positive, KDR/CD34 positive, CD133/CD34 positive, and CD117/CD34 positive cells. This decrease in CPC in obesity held true not only for the absolute cell numbers, but also for the relative fractions of KDR, CD133, and CD117 positive cells within the CD34 positive cells, indicating a specific down regulation of these progenitor cell types. Multiple regression analysis revealed that BMI was a more prominent predictor of CPC regulation than blood pressure, LDL cholesterol, triglycerides, fasting glucose, and smoking. IMT increased in dependence on BMI (P < 0.001) and was inversely correlated with the number of CD34 positive cell (P < 0.05). After diet, there was a significant increase of CD34 and CD117/CD34 positive cells, which correlated with the decrease in BMI. Also, weight loss was accompanied by a decrease in IMT (P = 0.015), which also correlated with the increase in CPC (P < 0.001). The increase in the number of CPC was independent from whether weight loss was achieved by increased physical exercise or by reduced calorie intake only.
Conclusion: Obesity is associated with decreased numbers of CPC and increased IMT. Diet and weight loss lead to an increase in CPC count, which might contribute to regression of IMT.
Key Words: Obesity • Diet • Risk factors • Endothelial function • Endothelial progenitor cells