title: Capillary permeability is increased in normo- and microalbuminuric type 1 diabetic patients: amelioration by ACE-inhibition.
abstract: 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.
authors.affiliation: Department of General Internal Medicine, University Hospital Groningen,the Netherlands.
authors.forename: P H
authors.initials: PH
authors.lastname: Oomen
authors.forename: J
authors.initials: J
authors.lastname: Jager
authors.forename: K
authors.initials: K
authors.lastname: Hoogenberg
authors.forename: R P
authors.initials: RP
authors.lastname: Dullaart
authors.forename: W D
authors.initials: WD
authors.lastname: Reitsma
authors.forename: A J
authors.initials: AJ
authors.lastname: Smit
mesh_terms: 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
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D004656:Enalapril; D019793:Fluorescein