title: Nailfold capillary abnormalities are associated with type 2 diabetes progression and correlated with peripheral neuropathy.
abstract: Diabetes mellitus (DM) is associated with a state of chronic hyperglycemia with a highly increased risk of vascular complications. The current study aimed to investigate microcirculation abnormalities in patients with type 2 DM and those with pre-DM using nailfold videocapillaroscopy (NVC) and evaluate the possible correlation with microvascular complications.A total of 115 patients with type 2 DM, 41 patients with pre-DM, and 37 healthy subjects without diabetes were enrolled. All subjects underwent NVC to evaluate capillary density, length, morphology, distribution, presence of enlarged loops or hemorrhages, and blood flow. NVC score was used to quantitate the aforementioned characteristics.Patients with type 2 DM showed significantly increased alterations including reduced capillary length (29.6%), irregular distribution (35.7%), and abnormal morphology (59.1%), while the corresponding NVC scores were comparable to those of control subjects. In addition, subjects with pre-DM had a significantly higher NVC score and greater alterations in distribution (26.8%) and morphology (48.8%) than control subjects. NVC score was positively correlated with diabetic peripheral neuropathy (DPN) and the number of microvascular complications.NVC identified a high frequency of microcirculation abnormalities in subjects with pre-DM or type 2 DM compared to those in the control group. NVC score was also capable of detecting microvascular complications in patients with type 2 DM and was correlated with DPN and the number of microvascular complications.
authors.affiliation: Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung Department of Chinese Medicine, Changhua Christian Hospital Department of Endocrinology, Changhua Christian Hospital School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, and Research Center for Chinese Medicine and Acupuncture, China Medical University Department of Chinese Medicine, China Medical University Hospital, Taichung Department of Computer Science and Engineering, National Sun Yat-sen University Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung School of Chinese Medicine, College of Chinese Medicine, China Medical University Department of Medical Research, China Medical University Hospital, Taichung Graduate Institute of Statistical and informational Science, National Changhua University of Education, Changhua, Taiwan.
authors.forename: Po-Chi
authors.initials: PC
authors.lastname: Hsu
authors.forename: Pei-Yung
authors.initials: PY
authors.lastname: Liao
authors.forename: Hen-Hong
authors.initials: HH
authors.lastname: Chang
authors.forename: John Y
authors.initials: JY
authors.lastname: Chiang
authors.forename: Yu-Chuen
authors.initials: YC
authors.lastname: Huang
authors.forename: Lun-Chien
authors.initials: LC
authors.lastname: Lo
mesh_terms: D002196:Capillaries / Q000473:pathology*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D003929:Diabetic Neuropathies / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D020678:Microscopic Angioscopy; D008875:Middle Aged; D009262:Nails / Q000098:blood supply* / Q000473:pathology