Neubauer-Geryk Jolanta, Myśliwiec Małgorzata, Zorena Katarzyna, Bieniaszewski Leszek
Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland.
Life (Basel). 2024 Dec 2;14(12):1587. doi: 10.3390/life14121587.
This study aimed to analyze the relationship between cutaneous microcirculation reactivity, retinal circulation, macrocirculation function, and specific adhesion molecules in young patients with uncomplicated type 1 diabetes. Fifty-five patients with type 1 diabetes mellitus (T1DM), aged 8 to 18 years, were divided into subgroups based on skin microcirculation reactivity. The cutaneous microcirculatory vessels were considered reactive if post-test PORH coverage increased compared to pre-test coverage. Optical coherence tomography (OCT) was conducted to detect early retinopathic changes. Macrocirculation was described using pulsatility indices (PIs) determined for common carotid (CCA) and peripheral arteries of the upper and lower limbs. The ankle-brachial index was also assessed. There were no significant differences in retinal circulation and macrocirculation between the studied subgroups. However, there were significant differences between the various subgroups concerning the age at onset of diabetes and the sP-selectin levels but not ICAM-1 and sVCAM-1. The sP-selectin differences remained true after adjusting for age at onset. The sP-selectin level was significantly higher in the subgroup of patients with non-reactive cutaneous microcirculation. The results of our study indicate that sP-selectin may be considered as an immunological marker for cutaneous abnormalities, which serve as an early indicator of endothelial dysfunction in young patients with type 1 diabetes in the absence of classical complication.
本研究旨在分析无并发症的1型糖尿病年轻患者皮肤微循环反应性、视网膜循环、大循环功能与特定黏附分子之间的关系。55例年龄在8至18岁的1型糖尿病（T1DM）患者根据皮肤微循环反应性被分为亚组。如果测试后PORH覆盖率相较于测试前覆盖率增加，则认为皮肤微循环血管具有反应性。采用光学相干断层扫描（OCT）检测早期视网膜病变改变。使用针对颈总动脉（CCA）以及上肢和下肢外周动脉测定的搏动指数（PI）来描述大循环。还评估了踝臂指数。在研究的亚组之间，视网膜循环和大循环无显著差异。然而，在糖尿病发病年龄和sP-选择素水平方面，各亚组之间存在显著差异，但在细胞间黏附分子-1（ICAM-1）和可溶性血管细胞黏附分子-1（sVCAM-1）方面无显著差异。在对发病年龄进行校正后，sP-选择素的差异依然存在。在皮肤微循环无反应性的患者亚组中，sP-选择素水平显著更高。我们的研究结果表明，sP-选择素可被视为皮肤异常的免疫标志物，而皮肤异常是无经典并发症的1型糖尿病年轻患者内皮功能障碍的早期指标。
