Association Between Maximum Lifetime Body Mass Index and Nailfold Capillary Changes in Patients With Type 2 Diabetes Mellitus.

OBJECTIVE

Microvascular changes, such as crossing nailfold capillaries, could be crucial for linking maximum lifetime body mass index (BMI) and microvascular complications in patients with type 2 diabetes mellitus (T2DM). However, the relationship between maximum lifetime BMI and microvascular changes remains elusive. This study aimed to elucidate the relationship between maximum lifetime BMI and the percentage of crossing nailfold capillaries among patients with T2DM.

METHODOLOGY

As an extension of a cross-sectional study at Osaka University Hospital, this study was conducted among 63 patients with T2DM aged 40-75 years. Maximum lifetime BMI data were extracted from medical records, and nailfold capillaroscopy was applied to assess capillary morphology, following the simple capillaroscopic definitions established by the European Alliance of Associations for Rheumatology Study Group. The association between maximum lifetime BMI and percentage of crossing fingernailfold capillaries was evaluated using multiple linear regression, adjusting for potential confounders such as age, sex, obesity status at the time of the survey, and other diabetes-related factors.

RESULTS

After adjusting for confounding factors, maximum lifetime BMI was significantly correlated with higher crossing capillary percentage (standardized regression coefficients: 0.47; = 0.026). BMI at the time of the survey showed no significant association with the percentage of crossing capillaries (standardized regression coefficients: -0.21; = 0.381).

CONCLUSIONS

Maximum lifetime BMI was associated with a higher percentage of crossing capillaries in patients with T2DM, rather than obesity status at the time of the survey. These results emphasize the importance of lifelong weight management in the prevention of T2DM and its complications and highlight the necessity of considering maximum lifetime BMI alongside current BMI in the management of patients with T2DM.