Fujiwara Y, Inukai T, Aso Y, Takemura Y
Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Japan.
Exp Clin Endocrinol Diabetes. 2000;108(7):463-9. doi: 10.1055/s-2000-8142.
To elucidate the relationship between the recovery of skin temperature in an extremity after exposure to cold water and various factors associated with diabetes, we measured skin temperature in type2 diabetic patients (N=61) and control subjects (N=16). A thermo-tracer was used in thermographic measurements. The right third toe of each subject was immersed in cold water at 0 degrees C for 10 sec. Rt represents the recovery rate of skin temperature at t min after exposure. Rt was significantly reduced in the diabetic patients every 5 min in the 20 min period following exposure compared with control subjects. The diabetic patients group exhibited a significantly positive correlation between R20 and the ankle-brachial index. R20 in the diabetic patients showed a significantly positive correlation with the reduction in systolic blood pressure at the arm observed in Schellong's test. In addition, R20 showed a significantly negative correlation with plasma levels of fibrinogen and plasminogen activator inhibitor-1. However, the severity of diabetic retinopathy and nephropathy was not significantly related to R20 in the diabetic patients. The present data indicate that the recovery of skin temperature after immersion in cold water was markedly reduced in patients with type 2 diabetes mellitus as compared with healthy control subjects. Peripheral arteriosclerosis, impaired sympathetic nerve function and the activation of the blood coagulation system may all contribute to this reduced recovery of skin temperature.
为了阐明肢体暴露于冷水后皮肤温度的恢复与糖尿病相关的各种因素之间的关系，我们测量了2型糖尿病患者（N = 61）和对照受试者（N = 16）的皮肤温度。热成像测量中使用了热示踪剂。将每个受试者的右第三趾浸入0摄氏度的冷水中10秒。Rt表示暴露后t分钟时皮肤温度的恢复率。与对照受试者相比，糖尿病患者在暴露后的20分钟内每5分钟的Rt均显著降低。糖尿病患者组中，R20与踝臂指数之间存在显著正相关。糖尿病患者的R20与在谢隆试验中观察到的手臂收缩压降低呈显著正相关。此外，R20与纤维蛋白原和纤溶酶原激活物抑制剂-1的血浆水平呈显著负相关。然而，糖尿病视网膜病变和肾病的严重程度与糖尿病患者的R20无显著相关性。目前的数据表明，与健康对照受试者相比，2型糖尿病患者冷水浸泡后皮肤温度的恢复明显降低。外周动脉硬化、交感神经功能受损和凝血系统激活可能都导致了皮肤温度恢复的降低。
