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Macro- and microcirculation in the lower extremities--possible relationship
Vilma Urbancic-Rovan1, Alan Bernjak, Aneta Stefanovska
1University Medical Centre, Department of Endocrinology, Diabetes and Metabolic Diseases, Zaloska 7, 1525 Ljubljana, Slovenia. vilma.urbancic@kclj.si
Diabetes Research and Clinical Practice
|February 2, 2006
Summary
Diabetic peripheral arterial obliterative disease (PAOD) does not alter microvascular skin blood flow. However, systolic pressure correlates with endothelial activity in diabetic patients, impacting blood flow oscillations.
Area of Science:
- Vascular Biology
- Diabetic Complications
- Microcirculation Research
Background:
- Impaired blood supply is a major risk factor for diabetic foot complications like ulceration and gangrene.
- Peripheral macroangiopathy (PAOD) is common in diabetic patients, potentially affecting microvascular function.
Purpose of the Study:
- To investigate the relationship between peripheral arterial obliterative disease (PAOD) and microvascular skin blood flow spectral components in diabetic patients.
- To compare these parameters between diabetic patients (DP) and non-diabetic controls (C).
Main Methods:
- Basal skin blood flow (BSBF) and its oscillatory components were measured using laser Doppler flowmetry and wavelet transform.
- Patients were categorized based on ankle/brachial index (ABI) into PAOD+ (ABI<0.9) and PAOD- (ABI 0.91-1.3) groups.
- Measurements were taken at the medial malleolus in 64 DP and 31 C.
Main Results:
- No significant differences in BSBF or its oscillatory components were found between PAOD+ and PAOD- groups in either DP or C.
- In diabetic patients, a specific spectral component of microvascular flow, linked to endothelial activity, showed a significant positive correlation with brachial and dorsal pedal systolic pressures.
Conclusions:
- Diabetic PAOD does not appear to alter mean BSBF or its overall oscillatory patterns.
- Systolic blood pressure is strongly correlated with endothelial-related microvascular flow oscillations in diabetic patients, specifically within the 0.0095-0.02Hz frequency range.