Low CD34+ cell count and metabolic syndrome synergistically increase the risk of adverse outcomes

Atherosclerosis. 2009 Nov;207(1):213-9. doi: 10.1016/j.atherosclerosis.2009.03.040. Epub 2009 Apr 5.


Objectives: Metabolic syndrome (MetS) associates with endothelial dysfunction and a high risk of cardiovascular events and death. Circulating progenitor cells have been shown to contribute to endothelial homeostasis and repair . We aimed to test whether progenitor cell count is an independent event predictor and modifies cardiovascular risk associated with MetS.

Methods: On the basis of the expression of CD34, CD133 and KDR, 6 phenotypes of progenitor cells were counted using flow cytometry in 214 subjects with and without MetS. We recorded classical risk factors and MetS components, cumulative risk estimates, and high-sensitive C-reactive protein. Subjects were followed-up for a median of 34 months to collect total events, cardiovascular events and all-cause mortality.

Results: In the Cox proportional hazards regression analyses, we found that, unlike other phenotypes, reduced CD34+ cells predicted cardiovascular and total events and death, independently of all potential confounders. Remarkably, a low CD34+ cell count significantly increased the risk associated with MetS, as shown by synergy indexes.

Conclusion: The level of circulating CD34+ cells is a novel independent risk biomarker and modulates outcomes in the MetS, suggesting that generic progenitor cells have a role in disease development or progression over the long-term.

MeSH terms

  • AC133 Antigen
  • Antigens, CD / blood
  • Antigens, CD34 / blood*
  • Biomarkers / blood
  • Cardiovascular Diseases / immunology*
  • Cardiovascular Diseases / mortality
  • Case-Control Studies
  • Cell Count
  • Disease Progression
  • Female
  • Flow Cytometry
  • Follow-Up Studies
  • Glycoproteins / blood
  • Humans
  • Male
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / immunology*
  • Metabolic Syndrome / mortality
  • Middle Aged
  • Peptides / blood
  • Phenotype
  • Predictive Value of Tests
  • Proportional Hazards Models
  • ROC Curve
  • Risk Assessment
  • Risk Factors
  • Stem Cells / immunology*
  • Time Factors
  • Vascular Endothelial Growth Factor Receptor-2 / blood


  • AC133 Antigen
  • Antigens, CD
  • Antigens, CD34
  • Biomarkers
  • Glycoproteins
  • PROM1 protein, human
  • Peptides
  • Vascular Endothelial Growth Factor Receptor-2