Endothelial impairment and bone marrow‐derived CD34⁺/133⁺ cells in diabetic patients with erectile dysfunction

Abstract

Aims/Introduction: The present study was undertaken to determine vascular endothelial impairment and endothelial progenitor cells (EPCs) in patients with type 2 diabetes mellitus and erectile dysfunction (ED). Materials and Methods: A total of 100 type 2 diabetic men were enrolled. Flow-mediated dilatation (FMD) and anaerobic threshold (AT) were measured. Also, EPCs in the peripheral blood were determined by flow cytometry. Results: In the 42 ED diabetic patients, FMD and AT were significantly less than those in the 58 patients with normal erectile function (FMD 2.84 vs 3.82%, P = 0.038, and AT 11.2 vs 12.7 mL/kg/min, P = 0.022). Exercise tolerance significantly increased the number of EPCs in the patients with and without ED (49-60 cells/100 lL, P = 0.015, and 72-99 cells/100 lL, P = 0.003). In the diabetic patients without autonomic neuropathy, FMD was significantly reduced in the patients with ED than those without ED (P = 0.015). In response to exercise tolerance, the number of EPCs increased in both the diabetic patients with ED (P = 0.003) and without ED (P = 0.007). In contrast, in the diabetic patients with autonomic neuropathy, there was no difference in FMD between the patients with and without ED. The exercise tolerance increased the number of EPCs in the patients without ED (P = 0.023), but it disappeared in those with ED. Conclusions: ED diabetic patients have endothelial impairment during the early period of diabetic complications, whose deranged endothelial function is concomitantly repaired by promoting bone marrow-derived EPCs. (J Diabetes Invest,

Vasculogenesis and Diabetic Erectile Dysfunction: How Relevant Is Glycemic Control?

“…In fact, contradictory findings have been reported in what regards cEPCs in diabetes. Several studies have presented a decrease in vascular progenitors in diabetic PB [Murata et al, ; Saito et al, ; Westerweel et al, ; Maiorino et al, ], whereas, others have shown an increase in these cell populations [Fadini et al, ; Liu et al, ; Flammer et al, ]. This relates to the so‐called diabetic angiogenic paradox [Costa, ].…”

“…Furthermore, it has been suggested that a good glycemic control, besides improving endothelial function and reducing oxidative markers [Fadini et al, ], and may also increase circulating EPCs (cEPCs) [Hortenhuber et al, ]. Several reports demonstrated a decrease in cEPCs levels in ED patients with cardiovascular risk factors, including diabetes [Murata et al, ; Maiorino et al, ]. A recent study, has showed a reduction of cEPCs in type 1 diabetics (T1D) with ED, which correlated with EDys and testosterone levels [Maiorino et al, ].…”

Association of serum osteoprotegerin with vascular calcification in patients with type 2 diabetes

“…FMD of the right brachial artery was determined by one investigator (AA) between 16:00 and 18:00 hours after a 15-minute rest, using a 12-MHz ultrasound instrument (UNEXEF18G, UNEX Corp., Nagoya, Japan), as previously described [17]. The brachial artery was imaged in the longitudinal section just above the antecubital fossa and internal diameters from the anterior to posterior intimal interfaces were measured at end-diastole using B-mode imaging as baseline.…”

The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

“…In all, 15 studies examined endothelial dysfunction as an outcome, with all these measuring FMD and none measuring RHI. [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Twelve studies examined cIMT outcomes, 28,34,35,38,40,[42][43][44][45][46][47][48] five studies measured CAC 28,29,37,49,50 and six studies had various measures of vascular stiffness and peripheral vascular disease such as PWV, Augmentation Index (AIx), ABI, and TBI. 28,[51][52][53][54][55] All the studies with FMD (n=15) and cIMT (n=12) outcomes were included in the meta-analysis regardless of their quality.…”

“…A total of 15 studies with 2025 participants examined the relationship between ED and FMD. [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] They all measured brachial FMD; however, the methods of FMD assessment were not universal among the studies. Seven of the 15 studies had the cuff placed on the forearm (including one which described the wrist), [28][29][30][31][32]37,39 while the others either had the cuff inflated over the arm 36,38,40,42 or did not specify.…”