Lamprou Stamatina, Koletsos Nikolaos, Zografou Ioanna, Lazaridis Antonios, Mintziori Gesthimani, Trakatelli Christina Maria, Kotsis Vasilios, Gkaliagkousi Eugenia, Doumas Michael, Triantafyllou Areti
Third Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece.
Second Propedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
J Clin Med. 2024 Aug 22;13(16):4957. doi: 10.3390/jcm13164957.
It is established that diabetes mellitus (DM) is characterized by increased cardiovascular risk associated with subclinical atherosclerosis as well as microvascular alterations. Laser speckle contrast analysis (LASCA) is an innovative, non-invasive method for assessing skin microvascular function. We sought to assess skin microvascular function in patients with type 2 DM and matched controls. Consecutive patients with DM and individuals matched for age, sex and BMI were included in the study. Skin microvascular perfusion was assessed, using LASCA, during baseline, a 5 min occlusion period and a 5 min reperfusion period. Carotid intima-media thickness (cIMT) was measured as a surrogate marker of macrocirculation. In total, 18 patients with DM and 22 in the control group were enrolled. No statistically significant differences were observed in baseline flux, peak flux and percentage decrease during arterial occlusion. During reperfusion, individuals with DM exhibited a smaller peak magnitude compared to controls (147.0 ± 64.7% vs. 189.4 ± 46.0%, respectively; < 0.05). Moreover, cIMT was higher in patients with DM compared to controls (0.68 ± 0.09 mm vs. 0.60 ± 0.08 mm, respectively, < 0.01) and was negatively correlated with skin microvascular reactivity in the univariate analysis. In the multivariate analysis, glucose and office systolic blood pressure levels remained significant predictors of microvascular reactivity. Our study shows that patients with type 2 DM exhibit impaired skin microvascular function compared to controls. Furthermore, glucose levels and blood pressure play a key role in microvascular dysfunction. However, additional studies are needed to address the clinical significance of early microvascular changes in DM.
已证实，糖尿病（DM）的特征是与亚临床动脉粥样硬化以及微血管改变相关的心血管风险增加。激光散斑对比分析（LASCA）是一种用于评估皮肤微血管功能的创新、非侵入性方法。我们试图评估2型糖尿病患者和匹配对照组的皮肤微血管功能。该研究纳入了连续的糖尿病患者以及年龄、性别和体重指数相匹配的个体。在基线期、5分钟阻断期和5分钟再灌注期，使用LASCA评估皮肤微血管灌注。测量颈动脉内膜中层厚度（cIMT）作为大循环的替代标志物。总共纳入了18例糖尿病患者和22例对照组。在动脉阻断期间，基线通量、峰值通量和减少百分比方面未观察到统计学上的显著差异。在再灌注期间，与对照组相比，糖尿病个体的峰值幅度较小（分别为147.0±64.7%和189.4±46.0%；P<0.05）。此外，糖尿病患者的cIMT高于对照组（分别为0.68±0.09毫米和0.60±0.08毫米，P<0.01），并且在单变量分析中与皮肤微血管反应性呈负相关。在多变量分析中，血糖和诊室收缩压水平仍然是微血管反应性的显著预测因素。我们的研究表明，与对照组相比，2型糖尿病患者的皮肤微血管功能受损。此外，血糖水平和血压在微血管功能障碍中起关键作用。然而，需要进一步的研究来探讨糖尿病早期微血管变化的临床意义。
