Dept. of Information Engineering, University of Florence, Italy.
Dept. of Clinical and Experimental Medicine, University of Florence, Italy.
Microvasc Res. 2019 Jul;124:91-96. doi: 10.1016/j.mvr.2019.04.002. Epub 2019 Apr 6.
The burden of type 1 diabetes (T1D) is growing worldwide, stressing the requirement to limit the threat of its long-term complications. In this regard, the development of methods for the early diagnosis and non-invasive monitoring of vascular abnormalities is widely recognized as one of the greatest priorities of the clinical research in this field.
To assess the deterioration of physiological properties extracted from laser Doppler flowmetry (LDF) signals of microvascular perfusion and, secondly, to investigate their association with the quality of long-term metabolic control.
Microvascular perfusion was recorded at the hallux of 63 control subjects and 47 T1D patients, whose glycaemic control was characterized in terms of the annual average levels of glycosylated haemoglobin (HbA1c). Pulse Decomposition Analysis was applied to the LDF data, in order to derive non-invasive markers of vascular stiffness based on a multi-Gaussian representation of the peripheral pulse waveforms; furthermore, wavelet transform analysis was used to evaluate the microvascular myogenic vasomotion and, finally, a physiological model of the reactive hyperaemia to a local thermal stimulus at 43 was used to test the integrity of the neurovascular pathways.
Compared to the control group, T1D patients showed a lower microvascular perfusion at baseline, and a larger vasodilatory reserve upon local heating, but no significant difference in myogenic activity. Moreover, the results of the PDA carried out on the LDF pulse waves, indicate the presence of a significant strong relation between large artery stiffness and the overall loss of glycaemic control over the past year.
1 型糖尿病（T1D）的负担在全球范围内不断增加，这就要求我们必须限制其长期并发症的威胁。在这方面，开发用于早期诊断和非侵入性监测血管异常的方法被广泛认为是该领域临床研究的最大重点之一。
评估从激光多普勒血流仪（LDF）信号中提取的微血管灌注生理特性的恶化情况，其次，研究其与长期代谢控制质量的关系。
在 63 名对照受试者和 47 名 T1D 患者的大脚趾处记录微血管灌注，其中患者的血糖控制情况用糖化血红蛋白（HbA1c）的年平均水平来描述。应用脉搏分解分析（PDA）对 LDF 数据进行分析，以便根据外周脉搏波形的多高斯表示来推导血管硬度的非侵入性标志物；此外，还使用小波变换分析评估微血管肌源性血管舒缩运动，最后，使用 43°C局部热刺激的反应性充血生理模型来测试神经血管通路的完整性。
与对照组相比，T1D 患者的基础微血管灌注较低，局部加热时的血管舒张储备较大，但肌源性活动无明显差异。此外，对 LDF 脉搏波进行 PDA 的结果表明，大动脉僵硬与过去一年整体血糖控制不佳之间存在显著的强相关性。
