Early vascular parameters in the micro- and macrocirculation in type 2 diabetes

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Ophthalmology

Background:

• Diabetes mellitus, particularly type 2 (T2DM), progresses from a metabolic disorder to a significant vascular disease over time.
• Vascular complications in T2DM are exacerbated by duration and coexisting risk factors like hypertension.
• Early detection of vascular damage is crucial for managing T2DM complications.

Purpose of the Study:

• To identify the earliest clinically detectable vascular parameter of organ damage in patients with T2DM.
• To compare various vascular remodeling parameters across renal, retinal, and systemic circulation.
• To understand the progression of vascular disease in T2DM.

Main Methods:

• Cross-sectional analysis of 111 T2DM patients and 54 non-diabetic controls.
• Assessed urinary albumin creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), retinal capillary flow (RCF), intercapillary distance (ICD), wall-to-lumen ratio (WLR), central systolic pressure (cSBP), and central pulse pressure (cPP).
• Utilized Scanning Laser Doppler Flowmetry and pulse wave analysis (Sphygmocor).

Main Results:

• Patients with T2DM showed significantly higher intercapillary distance (ICD) and central pulse pressure (cPP) compared to controls.
• T2DM patients exhibited significantly lower estimated glomerular filtration rate (eGFR).
• These differences persisted after adjusting for age, gender, and cardiovascular risk factors.

Conclusions:

• Retinal capillary rarefaction (ICD), reduced renal function (eGFR), and increased central pulse pressure (cPP) are early indicators of vascular damage in T2DM.
• These parameters are detected earlier than other micro- and macrocirculatory remodeling markers.
• Early detection of these vascular changes is vital for T2DM management.