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Skin microvascular endothelial dysfunction is associated with type 2 diabetes independently of microalbuminuria and arterial stiffness
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-4377-8544
Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, Faculty of Science & Engineering.ORCID iD: 0000-0002-9663-3720
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.ORCID iD: 0000-0002-1680-1000
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.ORCID iD: 0000-0002-9095-403X
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2017 (English)In: Diabetes & Vascular Disease Research, ISSN 1479-1641, E-ISSN 1752-8984, Vol. 14, no 4, 363-371 p., UNSP 1479164117707706Article in journal (Refereed) Published
Abstract [en]

Skin and kidney microvascular functions may be affected independently in diabetes mellitus. We investigated skin microcirculatory function in 79 subjects with diabetes type 2, where 41 had microalbuminuria and 38 not, and in 41 age-matched controls. The oxygen saturation, fraction of red blood cells and speed-resolved microcirculatory perfusion (% red blood cells x mm/s) divided into three speed regions: 0-1, 1-10 and above 10 mm/s, were assessed during baseline and after local heating of the foot with a new device integrating diffuse reflectance spectroscopy and laser Doppler flowmetry. Arterial stiffness was assessed as carotid-femoral pulse wave velocity. Subjects with diabetes and microalbuminuria had significantly higher carotid-femoral pulse wave velocity compared to subjects without microalbuminuria and to controls. The perfusion for speeds 0-1 mm/s and red blood cell tissue fraction were reduced in subjects with diabetes at baseline and after heating, independent of microalbuminuria. These parameters were correlated to HbA1c. In conclusion, the reduced nutritive perfusion and red blood cell tissue fraction in type 2 diabetes were related to long-term glucose control but independent of microvascular changes in the kidneys and large-vessel stiffness. This may be due to different pathogenic pathways in the development of nephropathy, large-vessel stiffness and cutaneous microvascular impairment.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2017. Vol. 14, no 4, 363-371 p., UNSP 1479164117707706
Keyword [en]
Skin blood flow; microalbuminuria; microcirculation; endothelial dysfunction; type 2 diabetes
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-139273DOI: 10.1177/1479164117707706ISI: 000403606900012PubMedID: 28482676OAI: oai:DiVA.org:liu-139273DiVA: diva2:1120923
Note

Funding Agencies|VINNOVA (Swedens innovation agency); Perimed AB through the SamBIO [2008-00149, 2011-03074]; NovaMedTech - European Union Regional Development Fund [68737, 160382]

Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2017-07-07

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Jonasson, HannaBergstrand, SaraNyström, Fredrik HLänne, TosteÖstgren, Carl JohanBjarnegård, NiclasFredriksson, IngemarLarsson, MarcusStrömberg, Tomas
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Division of Nursing ScienceFaculty of Medicine and Health SciencesBiomedical InstrumentationFaculty of Science & EngineeringDivision of Cardiovascular MedicineDepartment of EndocrinologyDepartment of Thoracic and Vascular SurgeryDivision of Community Medicine"Primary Health Care in Motala"Division of Biomedical Engineering
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