Neubauer-Geryk Jolanta, Wielicka Melanie, Hoffmann Magdalena, Myśliwiec Małgorzata, Bieniaszewski Leszek
Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Diabetology Outpatient Clinic, Non-Public Health Care Institution SAFMED, 83-000 Pruszcz Gdański, Poland.
Biomedicines. 2024 May 6;12(5):1020. doi: 10.3390/biomedicines12051020.
This study aimed to evaluate the earliest changes in the structure and function of the peripheral microcirculation using capillaroscopy and transcutaneous oxygen pressure measurement in children and adolescents with type 1 diabetes mellitus at baseline and during post-occlusive reactive hyperemia (PORH) in the function of diabetes duration. Sixty-seven patients with type 1 diabetes mellitus (T1D), aged 8 to 18 years, and twenty-eight age- and sex-matched healthy subjects were included in the analysis. Diabetic patients were divided into subgroups based on median disease duration. The subgroups differed in chronological age, lipid levels, and thyroid hormones. Capillaroscopy was performed twice: at baseline and then again after the PORH test. Transcutaneous oxygen pressure also was recorded under baseline conditions during and after the PORH test. Comparison of capillaroscopy and transcutaneous oxygen pressure parameters at rest and after the PORH showed no statistically significant difference between the subgroups. This remained true after adjusting for variables that differentiated the two subgroups. However, in the group of patients with long-standing diabetes, significant negative correlations were observed between the Coverage value after the PORH test and capillary reactivity with TcPO_zero (biological zero). Significant positive correlations were also found between distance after the PORH test and TcPO_zero. The results of our study indicate that in patients with a shorter duration of diabetes, the use of multiple tests provides a better characterization of the structure and function of microcirculation because the onset of dysfunction does not occur at the same time in all the tests.
本研究旨在通过毛细血管显微镜检查和经皮氧分压测量，评估1型糖尿病儿童和青少年在基线时以及闭塞后反应性充血（PORH）期间外周微循环结构和功能的最早变化，并探讨糖尿病病程对其的影响。分析纳入了67例年龄在8至18岁的1型糖尿病（T1D）患者以及28例年龄和性别匹配的健康受试者。糖尿病患者根据疾病持续时间的中位数分为亚组。这些亚组在实际年龄、血脂水平和甲状腺激素方面存在差异。毛细血管显微镜检查进行了两次：一次在基线时，另一次在PORH试验后。在基线条件下以及PORH试验期间和之后，还记录了经皮氧分压。比较静息状态和PORH试验后毛细血管显微镜检查和经皮氧分压参数，各亚组之间无统计学显著差异。在对区分两个亚组的变量进行调整后，情况依然如此。然而，在长期糖尿病患者组中，观察到PORH试验后的覆盖率值与毛细血管反应性与TcPO_zero（生物学零值）之间存在显著负相关。在PORH试验后的距离与TcPO_zero之间也发现了显著正相关。我们的研究结果表明，在糖尿病病程较短的患者中，使用多种测试能更好地表征微循环的结构和功能，因为功能障碍并非在所有测试中同时出现。
