Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.
Adv Exp Med Biol. 2018;1072:363-368. doi: 10.1007/978-3-319-91287-5_58.
Diabetes mellitus (DM)-associated hyperglycemia contributes to the initiation and progression of chronic microvascular (MIC) and macrovascular (MAC) complications. To carry out early identification of MIC, standardized and inexpensive tests are needed. Computerized nailfold video-capillaroscopy (CNVC) is a noninvasive tool to easily evaluate MIC at the level of the fingers and could be useful to detect the so-called 'diabetic capillaropathy'.
This was a prospective study using CNVC to examine the prevalence of capillaroscopic patterns in a cohort of type 1 (T1D) and type 2 (T2D) diabetic individuals, and to assess their relationship with the level of glycemic control (HbA1c) and DM-related complications.
Nailfold alterations were found to be more prevalent in diabetics, including tortuosity (p < 0.01), avascular zones (p < 0.01), ectasiae (p < 0.01) and capillary with bizarre shape (p < 0.01). At least two of these patterns were found with a higher prevalence in T1D and T2D individuals vs. controls (p < 0.01). Finally, a higher frequency of 'capillary score' equal to or higher than 2 points was found to be associated with worse glycemic control, and with the presence of diabetic retinopathy.
These results confirm the presence of a 'diabetic capillaropathy', and nailfold capillary alterations appear to be related to the level of glycemic control and the existence of MIC, particularly when retinal damage is involved.
本研究采用计算机化甲襞视频毛细血管镜(CNVC)检查 1 型(T1D)和 2 型(T2D)糖尿病患者的毛细血管模式,评估其与血糖控制(HbA1c)和糖尿病相关并发症的关系。
这是一项前瞻性研究,使用 CNVC 检查了 1 型(T1D)和 2 型(T2D)糖尿病患者的毛细血管模式的患病率,并评估了其与血糖控制(HbA1c)和糖尿病相关并发症的关系。
研究发现,糖尿病患者的甲襞改变更为常见,包括扭曲(p<0.01)、无血管区(p<0.01)、扩张(p<0.01)和奇异形状的毛细血管(p<0.01)。与对照组相比,T1D 和 T2D 个体中至少有两种这些模式更为常见(p<0.01)。最后,发现“毛细血管评分”等于或高于 2 分的频率与血糖控制较差以及存在糖尿病视网膜病变有关。
这些结果证实了存在“糖尿病毛细血管病”,并且甲襞毛细血管改变似乎与血糖控制水平以及微毛细血管的存在有关,尤其是当涉及视网膜损伤时。