Macro- and microcirculation in the lower extremities--possible relationship.
OBJECTIVE
Impaired blood supply is a significant risk factor for diabetic foot ulceration and gangrene. A possible relationship between peripheral macroangiopathy and the spectral components of microvascular skin blood flow in the lower extremities was tested in diabetic patients (DP) and non-diabetic subjects (C).


METHODS
Basal skin blood flow (BSBF) was recorded for 30min at the right and left medial malleolus (predominantly nutritive capillary circulation) by laser Doppler flowmetry in 64 DP and 31 C. Its oscillatory components were analyzed using wavelet transform. Peripheral arterial obliterative disease (PAOD) was defined according to ankle/brachial index (ABI): PAOD+ (ABI<0.9: 21 DP, 12 C), PAOD- (ABI 0.91-1.3: 43 DP, 19 C).


RESULTS
No statistically significant differences in BSBF and its oscillatory components were observed between PAOD+ and PAOD-, neither in DP nor in C. In DP, the spectral component of microvascular flow associated with endothelial activity was in significant positive correlation with systolic pressures on brachial and dorsal pedal artery (p=0.001 and 0.010, respectively).


CONCLUSIONS
These results indicate that mean BSBF and its oscillatory components do not change with diabetic PAOD; however there is a strong correlation between systolic pressure and the oscillatory components of BSBF related to endothelial activity manifested in the frequency interval 0.0095-0.02Hz.
Urbancic-Rovan
Vilma
V
University Medical Centre, Department of Endocrinology, Diabetes and Metabolic Diseases, Zaloska 7, 1525 Ljubljana, Slovenia. vilma.urbancic@kclj.si
Bernjak
Alan
A
Stefanovska
Aneta
A
Azman-Juvan
Katja
K
Kocijancic
Andreja
A
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D003920:Diabetes Mellitus / Q000503:physiopathology*; D017719:Diabetic Foot / Q000209:etiology*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D007866:Leg / Q000098:blood supply*; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D012867:Skin / Q000098:blood supply