动脉僵硬度与皮肤微血管功能之间的关联：SUVIMAX2研究和马斯特里赫特研究
Association Between Arterial Stiffness and Skin Microvascular Function: The SUVIMAX2 Study and The Maastricht Study.
作者信息
van Sloten Thomas T, Czernichow Sébastien, Houben Alfons J, Protogerou Athanase D, Henry Ronald M, Muris Dennis M, Schram Miranda T, Sep Simone J, Dagnelie Pieter C, van der Kallen Carla J, Schaper Nicolaas C, Blacher Jacques, Hercberg Serge, Levy Bernard I, Stehouwer Coen D
机构信息
Department of Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands;
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Epidemiology, Maastricht University Medical Centre, Maastricht, The Netherlands;
出版信息
Am J Hypertens. 2015 Jul;28(7):868-76. doi: 10.1093/ajh/hpu246. Epub 2014 Dec 17.
BACKGROUND
It has been hypothesized that arterial stiffness leads to generalized microvascular dysfunction and that individuals with type 2 diabetes mellitus (T2DM) are particularly prone to the detrimental effects of arterial stiffness. However, evidence for an association between stiffness and markers of generalized microvascular dysfunction is lacking. We therefore investigated the association between arterial stiffness and skin microvascular function in individuals without and with T2DM.
METHODS
Cross-sectional data were used of The Supplementation en Vitamines et Mineraux Antioxydants 2 (SUVIMAX2) Study (n = 284/62.2 years/48.6% women/0% T2DM (by design)) and The Maastricht Study (n = 737/59.7 years/45.2% women/28.8% T2DM (by design)). Arterial stiffness was determined by carotid-femoral pulse wave velocity (cfPWV). Skin capillaroscopy was used to determine capillary density at baseline, and during reactive hyperemia and venous congestion. Laser Doppler flowmetry was used to assess acetylcholine- and local heating-induced vasoreactivity, and skin flowmotion.
RESULTS
In The SUVIMAX2 Study, cfPWV (per +1 SD) was not associated with baseline capillary density (regression coefficient: -0.48 (95% confidence interval: 2.37; 1.41)) or capillary recruitment during venous congestion (0.54% (-0.74; 1.81%)). In addition, cfPWV was not associated with acetylcholine (-0.02% (-0.14; 0.10%)) or local heating-induced vasoreactivity (0.03% (-0.07; 0.12%)). In The Maastricht Study, in individuals without T2DM, cfPWV was not associated with baseline capillary density (-1.20 (-3.17; 0.77)), and capillary recruitment during reactive hyperemia (1.22% (-0.41; 2.84%)) or venous congestion (1.50% (-0.25; 3.25%)). In addition, cfPWV was not associated with flowmotion (-0.01 (-0.07; 0.06)). Results were adjusted for age and sex. Additional adjustments for confounders did not materially change these results. Results were qualitatively similar in individuals with T2DM.
CONCLUSIONS
Arterial stiffness is not associated with skin microvascular function, irrespective of the presence of T2DM.
背景
有假说认为动脉僵硬度会导致全身性微血管功能障碍，且2型糖尿病（T2DM）患者尤其容易受到动脉僵硬度的有害影响。然而，缺乏关于僵硬度与全身性微血管功能障碍标志物之间关联的证据。因此，我们研究了无T2DM个体和有T2DM个体的动脉僵硬度与皮肤微血管功能之间的关联。
方法
使用了补充抗氧化维生素和矿物质2（SUVIMAX2）研究（n = 284/62.2岁/48.6%为女性/0%患有T2DM（设计如此））和马斯特里赫特研究（n = 737/59.7岁/45.2%为女性/28.8%患有T2DM（设计如此））的横断面数据。通过颈股脉搏波速度（cfPWV）来测定动脉僵硬度。使用皮肤毛细血管显微镜检查来测定基线时、反应性充血期间和静脉充血期间的毛细血管密度。使用激光多普勒血流仪来评估乙酰胆碱和局部加热诱导的血管反应性以及皮肤血流运动。
结果
在SUVIMAX2研究中，cfPWV（每增加1个标准差）与基线毛细血管密度（回归系数：-0.48（95%置信区间：2.37；1.41））或静脉充血期间的毛细血管募集（0.54%（-0.74；1.81%））无关。此外，cfPWV与乙酰胆碱（-0.02%（-0.14；0.10%））或局部加热诱导的血管反应性（0.03%（-0.07；0.12%））无关。在马斯特里赫特研究中，在无T2DM的个体中，cfPWV与基线毛细血管密度（-1.20（-3.17；0.77））、反应性充血期间的毛细血管募集（1.22%（-0.41；2.84%））或静脉充血期间的毛细血管募集（1.50%（-0.25；3.25%））无关。此外，cfPWV与血流运动（-0.01（-0.07；0.06））无关。结果针对年龄和性别进行了调整。对混杂因素的进一步调整并未实质性改变这些结果。在患有T2DM的个体中，结果在定性上相似。
结论
无论是否存在T2DM，动脉僵硬度均与皮肤微血管功能无关。
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