title: Peripheral microvascular dysfunction as an independent predictor of atherosclerotic damage in type 1 diabetes patients: a preliminary study.
abstract: It has been recently hypothesized that peripheral microvascular dysfunction may contribute to atherosclerotic damage (AD) in diabetic patients. In order to test this hypothesis, we assessed forearm skin post-occlusive reactive hyperaemia (skin-PORH), an index of peripheral microvascular function, using laser-Doppler flowmetry, in 40 type 1 diabetes patients (T1D-pts), aged 49 ± 11 years, with no known cardiovascular complications, and in 50 age and sex-matched healthy control subjects (CS). T1D-pts also underwent carotid arteries ultrasound scanning (Ca-US) and ankle-brachial index (ABI) measurement. An arbitrary index of AD (AD-index), ranging from "0" (normal ABI, normal Ca-US) to "3" (abnormal ABI, one or more plaques at the Ca-US), was determined in T1D-pts. Linear and multiple regression analyses were performed to identify independent predictors of AD in T1D-pts. T1D-pts had a lower skin-PORH compared with CS (p = 0.015). In T1D-pts AD-index resulted to be negatively related with skin-PORH (R = 0.44; p < 0.005) or deep-breathing test (DBT) (R = 0.53; p < 0.0005), and positively related with systolic arterial pressure (R = 0.31; p < 0.05), microalbuminuria (R = 0.46; p < 0.005), patients' age (R = 0.51; p < 0.001) and diabetes duration (R = 0.39; p < 0.05). At the multiple regression analysis skin-PORH (R = 0.36; p < 0.005), patients' age R = 0.24; p < 0.05) and DBT (R = 0.4 - p < 0.005) resulted to be independent predictors of AD-index in T1D-pts. These preliminary findings support the hypothesis that peripheral microvascular dysfunction may contribute to AD in T1D-pts.
authors.affiliation: Department of Internal Medicine, University-Hospital of Pisa, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rossi
authors.forename: Elena
authors.initials: E
authors.lastname: Matteucci
authors.forename: Margherita
authors.initials: M
authors.lastname: Pesce
authors.forename: Cristina
authors.initials: C
authors.lastname: Consani
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Franzoni
authors.forename: Gino
authors.initials: G
authors.lastname: Santoro
authors.forename: Ottavio
authors.initials: O
authors.lastname: Giampietro
mesh_terms: D050197:Atherosclerosis / Q000473:pathology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged
keywords: Microvascular dysfunction; ankle-brachial index; atherosclerosis; carotid intima-media thickness; laser-Doppler flowmetry; skin post-occlusive reactive hyperaemia; type 1 diabetes