Abstract
The present study was designed to study skin capillary density and recruitment of the upper and lower extremities in patients with type 1 diabetes with vascular complications, when compared to patients without complications and healthy subjects. We used intravital video-microscopy to measure basal and maximal (during venous congestion) skin capillary densities as well as capillary recruitment using post-occlusive reactive hyperemia (PORH) in the dorsum of the fingers and toes.Our results showed that besides microvascular vasodilation and loss of autoregulatory capacity, patients with type 1 diabetes with vascular complications present increased skin capillary density in both extremities.
Highlights
The absence of capillary recruitment in both extremities during post-occlusive reactive hyperemia (PORH), which is related to endothelium-dependent vasodilation at the pre-capillary level, in
Functional density corresponds to values obtained during PORH, while maximal skin capillary density was evaluated using venous
The absence of capillary recruitment in these patients suggests that diabetic capillaries at rest are already recruited maximally as well as a loss of microvascular autoregulatory capacity
Summary
Intravital video microscopy was carried out in the morning using a standardized and well-validated technique [47] in a temperature-controlled room (21-24°C). Subjects were seated and the skin of the dorsum of the middle phalanx of the left hand and proximal phalanx of the great toe (page number not for citation purposes). Years Male, n (%) Smokers, n (%) Body mass index, kg/m2 Diabetes duration, years HbA1c MUAE, μg/min. HbA1c, glycated hemoglobin; MUAE, mean urinary albumin excretion rate. Capillary density was defined as the total number of spontaneously perfused capillaries per mm of skin. Percentage capillary recruitment was assessed by post-occlusive reactive hyperemia (PORH) after stopping arterial blood flow to the forearm and hand or to the foot by inflating a sphygmomanometer cuff over 3 min to 200 mmHg. Ten minutes after PORH, maximization of skin capillaries was obtained with 2 minutes of venous occlusion inflating the cuff to 60 mmHg (upper limb) or 90 mmHg (lower limb). Data were analyzed by SPSS 13.0 and the Student's t test, Mann-Whitney, Wilcoxon and X2 tests were used when indicated. p values < 0.05 were considered statistically significant
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