3.8 Article

Nailfold capillaroscopy and microvascular involvement in Diabetes Mellitus

Journal

SCIENTIA MEDICA
Volume 31, Issue 1, Pages -

Publisher

EDITORA PUCRS
DOI: 10.15448/1980-6108.2021.1.39679

Keywords

diabetes mellitus; microcirculation; diabetic retinopathy; microscopic angioscopy

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The study revealed that diabetic patients had decreased capillary density and increased dilatation in nailfold capillaroscopy compared to controls. Capillary density correlated with age, retinopathy, use of antiplatelet medication, HbA1c, microalbuminuria, and diabetes duration. Dilatations were associated with retinopathy, glomerular filtration rate, and longer disease duration.
Objective: to study the relationship between microvascular lesions of Diabetes Mellitus and alterations in the nailfold capillaroscopy. Subjects and Methods: cross-sectional study including 140 individuals (70 with Diabetes Mellitus and 70 controls). Epidemiological and clinical variables were collected from patient's charts. Fundus ophthalmoscopy, nailfold capillaroscopy, analysis of microalbuminuria and renal clearance as well as fasting glycaemia and HbA1c values were studied simultaneously. Results: capillary density was reduced, and vascular dilatation was increased in Diabetes Mellitus patients when compared to controls (both with p<0.0001). In diabetic individuals the number of dermal papillary capillaries/mm(3) correlated negatively with microalbuminuria (p=0.02), patient's age (p=0.03), values of HbA1c (p=0.03). Patients with diabetic retinopathy and using antiplatelet agents had lower capillary density (p<0.0001 and 0.04 respectively). Capillary dilatation was associated with disease duration (p=0.04). Conclusion: microvascular disease in Diabetes Mellitus is reflected in nailfold capillaroscopy. Decreased capillary density, increased number of ectasias and increased presence of avascular areas were observed in patients with diabetes when compared to controls. In the present study, capillary density correlated/associate with age, retinopathy, use of antiplatelet medication, HbA1c, microalbuminuria and diabetes duration. Ectasias or dilatations were related to retinopathy, glomerular filtration rate and longer disease duration.

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