Reference value of transcutaneous oxygen measurement in diabetic patients compared with nondiabetic patients.
OBJECTIVE
This study evaluated the values of transcutaneous oxygen tension (TcPo(2)) measurement in diabetic patients compared with nondiabetic patients and assessed its reproducibility.


METHODS
In 60 diabetic patients (type 1 and type 2 diabetes mellitus) without signs of peripheral arterial disease or neuropathy, we measured TcPo(2) at the chest and foot and compared these measurements with 60 age- and sex-matched nondiabetic patients in a cross-sectional fashion. The reproducibility of TcPo(2) in terms of interobserver variability was also assessed.


RESULTS
Diabetic patients had a mean +/- SD TcPo(2) value at the foot of 50.02 +/- 8.92 mm Hg, which was significantly lower compared with 56.04 +/- 8.80 mm Hg in nondiabetic patients (P < .001). At the chest wall, values for TcPo(2) were 51.77 +/- 11.15 mm Hg, and 58.22 +/- 12.47 mm Hg for diabetic patients and nondiabetic patients, respectively (P = .003). Regression analysis showed that TcPo(2)was significantly associated with diabetes mellitus (coefficient = -0.258; P = .004), and with having a first-degree relative with diabetes mellitus (coefficient = -0.265; P = .003). Furthermore, the interobserver variability showed a substantial correlation for both measurements at the chest (P < .001; r = 0.654; intraclass correlation coefficient [ICC] = 0.79) and at the dorsum of the foot (P < .001; r = 0.426; ICC = 0.60).


CONCLUSIONS
Diabetic patients without signs of peripheral disease or neuropathy had significantly lower TcPo(2) values compared with age- and sex-matched nondiabetic patients. The influence of the examiner on the variance in TcPo(2) measurements was relatively small. We advocate the use of TcPo(2) measurement in diabetic patients to detect subclinical microvascular impairment as an additional tool to assess peripheral vascular disease.
Department of Surgery, Ikazia Hospital, Rotterdam, The Netherlands.
Vincent E
VE
de Meijer
Hans P
HP
Van't Sant
Sandra
S
Spronk
Freek J
FJ
Kusters
Pieter T
PT
den Hoed
D000328:Adult; D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010100:Oxygen / Q000378:metabolism*; D016491:Peripheral Vascular Diseases / Q000503:physiopathology; D012016:Reference Values; D012044:Regression Analysis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D001786:Blood Glucose; D010100:Oxygen