Wielicka Melanie, Neubauer-Geryk Jolanta, Brandt-Varma Agnieszka, Myśliwiec Małgorzata, Bieniaszewski Leszek
Medical University of Gdansk, Gdansk, Poland.
Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdansk, Gdansk, Poland.
Pediatr Endocrinol Diabetes Metab. 2019;25(4):183-187. doi: 10.5114/pedm.2019.89641.
Skin microcirculation is recognized as an appropriate model to use when investigating the relationship between cardiovascular risk factors and microvascular function. It is currently a matter of debate whether studies on skin microcirculation in young type 1 diabetic patients without existing microangiopathy may be helpful in identifying subjects with impaired endothelial function.
To evaluate the potential changes in skin microcirculation of patients up age of 18 years using capillaroscopy, post reactive hyperaemia (PORH) and venous occlusion (VO) tests, and to establish the relationship between those changes and disease duration and metabolic control in patients with type 1 diabetes.
Study group consisted of 112 pediatric patients aged 8.4-18.0 years, with a median age of 14.95 years. The median diabetes duration and age at onset were 5 years and 9.6 years, respectively. The median HbA1c in the studied group was 7.6% at the time when the microcirculation was being examined. Capillaroscopy studies were focused on type 1 diabetic patients and employed non-selective stimuli such as the PORH and VO tests. The relative area covered by capillaries (coverage) was measured before the testing and again after the PORH and VO tests.
The analysis revealed that none of the skin microcirculation indices correlated significantly with patient age, diabetes duration or metabolic control.
In young patients with uncomplicated type 1 diabetes mellitus skin microcirculation function is not dependent on age, disease duration or metabolic control.
皮肤微循环被认为是研究心血管危险因素与微血管功能之间关系时适用的模型。对于尚无微血管病变的年轻1型糖尿病患者进行皮肤微循环研究是否有助于识别内皮功能受损的个体，目前仍存在争议。
使用毛细血管显微镜检查、反应性充血后（PORH）和静脉闭塞（VO）试验评估18岁以下患者皮肤微循环的潜在变化，并确定这些变化与1型糖尿病患者病程和代谢控制之间的关系。
研究组由112名年龄在8.4 - 18.0岁的儿科患者组成，中位年龄为14.95岁。糖尿病病程和发病年龄的中位数分别为5年和9.6岁。在检查微循环时，研究组的HbA1c中位数为7.6%。毛细血管显微镜检查研究针对1型糖尿病患者，采用非选择性刺激，如PORH和VO试验。在测试前以及PORH和VO试验后再次测量毛细血管覆盖的相对面积（覆盖率）。
分析显示，皮肤微循环指标均与患者年龄、糖尿病病程或代谢控制无显著相关性。
在无并发症的年轻1型糖尿病患者中，皮肤微循环功能不依赖于年龄、病程或代谢控制。
