Hsu Po-Chi, Liao Pei-Yung, Chang Hen-Hong, Chiang John Y, Huang Yu-Chuen, Lo Lun-Chien
Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung Department of Chinese Medicine, Changhua Christian Hospital Department of Endocrinology, Changhua Christian Hospital School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, and Research Center for Chinese Medicine and Acupuncture, China Medical University Department of Chinese Medicine, China Medical University Hospital, Taichung Department of Computer Science and Engineering, National Sun Yat-sen University Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung School of Chinese Medicine, College of Chinese Medicine, China Medical University Department of Medical Research, China Medical University Hospital, Taichung Graduate Institute of Statistical and informational Science, National Changhua University of Education, Changhua, Taiwan.
Medicine (Baltimore). 2016 Dec;95(52):e5714. doi: 10.1097/MD.0000000000005714.
Diabetes mellitus (DM) is associated with a state of chronic hyperglycemia with a highly increased risk of vascular complications. The current study aimed to investigate microcirculation abnormalities in patients with type 2 DM and those with pre-DM using nailfold videocapillaroscopy (NVC) and evaluate the possible correlation with microvascular complications.A total of 115 patients with type 2 DM, 41 patients with pre-DM, and 37 healthy subjects without diabetes were enrolled. All subjects underwent NVC to evaluate capillary density, length, morphology, distribution, presence of enlarged loops or hemorrhages, and blood flow. NVC score was used to quantitate the aforementioned characteristics.Patients with type 2 DM showed significantly increased alterations including reduced capillary length (29.6%), irregular distribution (35.7%), and abnormal morphology (59.1%), while the corresponding NVC scores were comparable to those of control subjects. In addition, subjects with pre-DM had a significantly higher NVC score and greater alterations in distribution (26.8%) and morphology (48.8%) than control subjects. NVC score was positively correlated with diabetic peripheral neuropathy (DPN) and the number of microvascular complications.NVC identified a high frequency of microcirculation abnormalities in subjects with pre-DM or type 2 DM compared to those in the control group. NVC score was also capable of detecting microvascular complications in patients with type 2 DM and was correlated with DPN and the number of microvascular complications.
糖尿病(DM)与慢性高血糖状态相关,血管并发症风险大幅增加。本研究旨在使用甲襞微血管造影术(NVC)调查2型糖尿病患者和糖尿病前期患者的微循环异常情况,并评估其与微血管并发症的可能相关性。共纳入115例2型糖尿病患者、41例糖尿病前期患者和37例无糖尿病的健康受试者。所有受试者均接受NVC检查,以评估毛细血管密度、长度、形态、分布、是否存在扩张环或出血以及血流情况。NVC评分用于量化上述特征。2型糖尿病患者的改变显著增加,包括毛细血管长度缩短(29.6%)、分布不规则(35.7%)和形态异常(59.1%),而相应的NVC评分与对照组相当。此外,糖尿病前期受试者的NVC评分显著高于对照组,分布(26.8%)和形态(48.8%)的改变也更大。NVC评分与糖尿病周围神经病变(DPN)和微血管并发症数量呈正相关。与对照组相比,NVC发现糖尿病前期或2型糖尿病受试者的微循环异常频率较高。NVC评分还能够检测2型糖尿病患者的微血管并发症,并与DPN和微血管并发症数量相关。