Change in circulating levels of endothelial progenitor cells and sexual function in women with type 1 diabetes

Context: Endothelial progenitor cells (EPCs), which are involved in the mechanisms of vascular repair, and sexual function are decreased in diabetic women as compared with general population. Objective: To investigate the circulating levels of EPCs and the change in sexual function during the menstrual cycle in women with type 1 diabetes (T1DM) compared with healthy women. Design: Case-control observational study. Setting: Unit of Endocrinology and Metabolic Diseases at University Hospital "Luigi Vanvitelli'' of Naples. Patients: Thirty-six women with T1DM and 64 age-matched healthy controls. Intervention: EPCs were quantified by flow cytometry and sexual function was assessed using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale. All the assessments were made at the follicular, ovulatory and luteal phases of the same menstrual cycle. Main outcome measures: Differences in EPCs levels and sexual function between patients and controls. Results: Compared with controls, women with diabetes showed significantly lower levels of both CD34+ (P < 0.001) and CD34+CD133+ cells (P < 0.001) in the ovulatory phase, and CD34+KDR+ cells in both the ovulatory phase and in the luteal phase (P < 0.001 for both). Diabetic women showed significantly lower total FSFI scores and higher FSDS score than control women in all the phases of the menstrual cycle. FSFI total score was predicted by both CD34+CD133+ and CD34+KDR+ cells in the follicular phase, CD34+ and CD34+KDR+CD133+ cells in the ovulatory phase, CD34+KDR+ and CD34+KDR+CD133+ cells in the luteal phase. Conclusion: Women with T1DM show lower levels of EPCs during the menstrual cycle, compared with controls. EPCs count predict sexual function in this selected population.