Τίτλος:
The association of diabetic microvascular and macrovascular disease with cutaneous circulation in patients with type 2 diabetes mellitus
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims: To study the impact of diabetic neuropathy, both peripheral sensorimotor (DPN) and cardiac autonomic neuropathy (CAN), on transcutaneous oxygen tension (TcPO2) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 163 participants were recruited; 100 with T2DM and 63 healthy individuals. Peripheral arterial disease (PAD) was defined as ankle-brachial index (ABI) values ≤0.90. Diagnosis of DPN was based on neuropathy symptom score and neuropathy disability score (NDS), while diagnosis of CAN on the battery of the cardiovascular autonomic function tests. TcPO2 was measured using a TCM30 system. Results: Patients with T2DM had lower TcPO2 levels when compared with healthy individuals. Among the diabetic cohort, those who had either PAD, DPN or CAN had significantly lower TcPO2 values than participants without these complications. Multivariate linear regression analysis, after controlling for diabetes duration, diastolic blood pressure, HbA1c, albumin to creatinine ratio and CAN score, demonstrated that TcPO2 levels were significantly and independently associated with current smoking (p = 0.013), ABI (p = 0.003), and NDS (p = 0.013). Conclusion: Presence of DPN is independently associated with impaired cutaneous perfusion. Low TcPO2 in subjects with DPN may contribute to delay in healing of diabetic foot ulcers, irrespectively of PAD. © 2018 Elsevier Inc.
Συγγραφείς:
Eleftheriadou, I.
Tentolouris, A.
Grigoropoulou, P.
Tsilingiris, D.
Anastasiou, I.
Kokkinos, A.
Perrea, D.
Katsilambros, N.
Tentolouris, N.
Περιοδικό:
Journal of Diabetes and its Complications
Εκδότης:
W B SAUNDERS CO-ELSEVIER INC
Λέξεις-κλειδιά:
albumin; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; cholesterol; creatinine; dipeptidyl carboxypeptidase inhibitor; hemoglobin A1c; high density lipoprotein cholesterol; low density lipoprotein cholesterol; nicotinamide adenine dinucleotide; triacylglycerol, adult; aged; ankle brachial index; ankle pressure; Article; cardiac autonomic neuropathy; cholesterol blood level; creatinine blood level; cross-sectional study; diabetic foot; diabetic neuropathy; diastolic blood pressure; disease association; disease duration; female; human; major clinical study; male; middle aged; non insulin dependent diabetes mellitus; peripheral occlusive artery disease; priority journal; skin blood flow; smoking; systolic blood pressure; transcutaneous oxygen monitoring; triacylglycerol blood level; autonomic neuropathy; blood; case control study; complication; diabetic angiopathy; diabetic neuropathy; diagnostic imaging; electrocardiography; heart; heart rate; innervation; microcirculation; non insulin dependent diabetes mellitus; pathophysiology; peripheral occlusive artery disease; physiology; skin; vascularization, Aged; Ankle Brachial Index; Autonomic Nervous System Diseases; Blood Gas Monitoring, Transcutaneous; Case-Control Studies; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Diabetic Neuropathies; Electrocardiography; Female; Heart; Heart Rate; Humans; Male; Microcirculation; Middle Aged; Peripheral Arterial Disease; Skin
DOI:
10.1016/j.jdiacomp.2018.10.008
