Non-invasive detection of early microvascular changes in juveniles with type 1 diabetes

Bogusz-Górna, Klaudia; Polańska, Adriana; Dańczak-Pazdrowska, Aleksandra; Żaba, Ryszard; Sumińska, Marta; Fichna, Piotr; Kędzia, Andrzej

doi:10.1186/s12933-023-02031-y

Cited by 4 publications

(2 citation statements)

References 45 publications

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“…They showed that male participants had lower subpapillary venous plexus visibility scores, but other capillary parameters did not differ between the sexes. Similarly, no gender differences in capillaroscopic parameters were found in a study by Bogusz-Górna et al in a group of children and adolescents with type 1 diabetes [73]. It should be noted that in these studies, a qualitative approach in analyzing the capillaroscopy results was used, while we had the advantage of performing a quantitative description of the capillaries.…”

Section: Discussionmentioning

confidence: 87%

Gender-Related Difference in Skin Oxygenation in Young Patients with Uncomplicated Type 1 Diabetes

Neubauer-Geryk,

Myśliwiec,

Bieniaszewski

2024

Biomedicines

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Gender, through genetic, epigenetic and hormonal regulation, is an important modifier of the physiological mechanisms and clinical course of diseases. In diabetes mellitus, there are gender differences in incidence, prevalence, morbidity, and mortality. This disease also has an impact on the microvascular function. Therefore, this cross-sectional study was designed to investigate how gender affects the cutaneous microcirculation. We hypothesized that gender should be an important factor in the interpretation of capillaroscopy and transcutaneous oxygen saturation results. The study group consisted of 42 boys and 55 girls, uncomplicated diabetic pediatric patients. Females (F) and males (M) did not differ in terms of age, age at onset of diabetes, or diabetes duration. Furthermore, they did not differ in metabolic parameters. The comparison showed that group F had lower BP, higher pulse, and higher HR than group M. Group F had significantly lower creatinine and hemoglobin levels than group M. In children and adolescents with type 1 diabetes without complications, there was a gender difference in microcirculatory parameters. The resting transcutaneous partial pressure of oxygen was significantly higher in females than in males. However, there were no gender-related differences in basal capillaroscopic parameters or vascular reactivity during the PORH test. Our results indicate that studies investigating the structure and function of the microcirculation should consider the role of gender in addition to known cofactors such as puberty, body mass index, physical activity, and cigarette smoking.

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Section: Discussionmentioning

confidence: 87%

Gender-Related Difference in Skin Oxygenation in Young Patients with Uncomplicated Type 1 Diabetes

Neubauer-Geryk,

Myśliwiec,

Bieniaszewski

2024

Biomedicines

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“…Reports published to date on the relationship between skin microvascular parameters and metabolic control in patients with T1D have not been consistent [7,52,58,60,[63][64][65]. Some studies have shown that cutaneous microvascular reactivity is independent of metabolic status reflected by HbA 1c values [52,58,60,66]. Meanwhile, in a group of adult patients, Jorneskog et al [64] showed significant differences in capillary flow between patients with poor and good metabolic control regardless of diabetes duration.…”

Section: Metabolic Controlmentioning

confidence: 99%

The Impact of Disease Duration on Microcirculatory Dysfunction in Young Patients with Uncomplicated Type 1 Diabetes

Neubauer-Geryk,

Wielicka,

Hoffmann

et al. 2024

Biomedicines

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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 TcPO2_zero (biological zero). Significant positive correlations were also found between distance after the PORH test and TcPO2_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.

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Determinants of vascular impairment in type 1 diabetes–impact of sex and connexin 37 gene polymorphism: A cross-sectional study

Piťhová,

Cichrová,

Kvapil

et al. 2024

Cardiovasc Diabetol

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Background The associations of risk factors with vascular impairment in type 1 diabetes patients seem more complex than that in type 2 diabetes patients. Therefore, we analyzed the associations between traditional and novel cardiovascular risk factors and vascular parameters in individuals with T1D and modifications of these associations according to sex and genetic factors. Methods In a cross-sectional study, we analyzed the association of risk factors in T1D individuals younger than 65 years using vascular parameters, such as ankle brachial index (ABI) and toe brachial index (TBI), duplex ultrasound, measuring the presence of plaques in carotid and femoral arteries (Belcaro score) and intima media thickness of carotid arteries (CIMT). We also used photoplethysmography, which measured the interbranch index expressed as the Oliva-Roztocil index (ORI), and analyzed renal parameters, such as urine albumin/creatinine ratio (uACR) and glomerular filtration rate (GFR). We evaluated these associations using multivariate regression analysis, including interactions with sex and the gene for connexin 37 (Cx37) polymorphism (rs1764391). Results In 235 men and 227 women (mean age 43.6 ± 13.6 years; mean duration of diabetes 22.1 ± 11.3 years), pulse pressure was strongly associated with unfavorable values of most of the vascular parameters under study (ABI, TBI, Belcaro scores, uACR and ORI), whereas plasma lipids, represented by remnant cholesterol (cholesterol – LDL-HDL cholesterol), the atherogenic index of plasma (log (triglycerides/HDL cholesterol) and Lp(a), were associated primarily with renal impairment (uACR, GFR and lipoprotein (a)). Plasma non-HDL cholesterol was not associated with any vascular parameter under study. In contrast to pulse pressure, the associations of lipid factors with kidney and vascular parameters were modified by sex and the Cx37 gene. Conclusion In addition to known information, easily obtainable risk factor, such as pulse pressure, should be considered in individuals with T1D irrespective of sex and genetic background. The associations of plasma lipids with kidney function are complex and associated with sex and genetic factors. The decision of whether pulse pressure, remnant lipoproteins, Lp(a) and other determinants of vascular damage should become treatment targets in T1D should be based on the results of future clinical trials. Graphical Abstract

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Non-invasive detection of early microvascular changes in juveniles with type 1 diabetes

Cited by 4 publications

References 45 publications

Gender-Related Difference in Skin Oxygenation in Young Patients with Uncomplicated Type 1 Diabetes

Gender-Related Difference in Skin Oxygenation in Young Patients with Uncomplicated Type 1 Diabetes

The Impact of Disease Duration on Microcirculatory Dysfunction in Young Patients with Uncomplicated Type 1 Diabetes

Determinants of vascular impairment in type 1 diabetes–impact of sex and connexin 37 gene polymorphism: A cross-sectional study

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