Capillary permeability is increased in normo- and microalbuminuric type 1 diabetic patients: amelioration by ACE-inhibition.
BACKGROUND
Capillary leakage of sodium-fluorescein (NaF) in the skin reflects capillary permeability and may be a marker of diabetes-associated microcirculatory abnormalities.


METHODS
We evaluated transcapillary skin NaF leakage by fluorescence videodensitometry in 10 normoalbuminuric, 10 microalbuminuric Type 1 diabetic men (diabetes duration > 10 years) and 10 healthy subjects. The microalbuminuric patients were restudied after 6 weeks treatment with the ACE-inhibitor enalapril, 10 mg once daily. All measurements were performed at a blood glucose level of 5 mmol L-1.


RESULTS
Transcapillary NaF leakage was strongly increased in normoalbuminuric Type 1 diabetic patients compared to healthy subjects (P < 0.001) and was still further increased in microalbuminuric Type 1 diabetic patients (P < 0.01 compared to normoalbuminuric patients). Enalapril reduced NaF leakage (P < 0.05), mean arterial blood pressure (P < 0.05) and microalbuminuria (P < 0. 05). After treatment, NaF leakage was not different from that in normoalbuminuric patients.


CONCLUSIONS
Capillary permeability, as determined by NaF leakage, is elevated in normoalbuminuric Type 1 diabetic patients with long-standing disease, and the excess elevation in microalbuminuric Type 1 diabetic patients is ameliorated by ACE-inhibition. Skin NaF videodensitometry seems a useful tool to document capillary permeability in intervention studies.
Oomen
P H
PH
Department of General Internal Medicine, University Hospital Groningen,the Netherlands.
Jager
J
J
Hoogenberg
K
K
Dullaart
R P
RP
Reitsma
W D
WD
Smit
A J
AJ
D000419:Albuminuria / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D001786:Blood Glucose / Q000378:metabolism; D002199:Capillary Permeability / Q000187:drug effects*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D004656:Enalapril / Q000494:pharmacology / Q000627:therapeutic use*; D019793:Fluorescein / Q000493:pharmacokinetics; D006801:Humans; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D012867:Skin / Q000378:metabolism
D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D004656:Enalapril; D019793:Fluorescein