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Computerized Video-Capillaroscopy Alteration Related to Diabetes Mellitus and Its Complications

  • Giuseppe Lisco
  • Giuseppe Cicco
  • Angelo Cignarelli
  • Gabriella Garruti
  • Luigi Laviola
  • Francesco Giorgino
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1072)

Abstract

Diabetes mellitus (DM)-associated hyperglycemia contributes to the initiation and progression of chronic microvascular (MIC) and macrovascular (MAC) complications. To carry out early identification of MIC, standardized and inexpensive tests are needed. Computerized nailfold video-capillaroscopy (CNVC) is a noninvasive tool to easily evaluate MIC at the level of the fingers and could be useful to detect the so-called ‘diabetic capillaropathy’. Aim: This was a prospective study using CNVC to examine the prevalence of capillaroscopic patterns in a cohort of type 1 (T1D) and type 2 (T2D) diabetic individuals, and to assess their relationship with the level of glycemic control (HbA1c) and DM-related complications. Results: Nailfold alterations were found to be more prevalent in diabetics, including tortuosity (p < 0.01), avascular zones (p < 0.01), ectasiae (p < 0.01) and capillary with bizarre shape (p < 0.01). At least two of these patterns were found with a higher prevalence in T1D and T2D individuals vs. controls (p < 0.01). Finally, a higher frequency of ‘capillary score’ equal to or higher than 2 points was found to be associated with worse glycemic control, and with the presence of diabetic retinopathy. Conclusions: These results confirm the presence of a ‘diabetic capillaropathy’, and nailfold capillary alterations appear to be related to the level of glycemic control and the existence of MIC, particularly when retinal damage is involved.

Abbreviations

ACR

Albumin/creatinine ratio

CKD

Chronic kidney disease

CNVC

Computerized nailfold video-capillaroscopy

CS

Capillary score

DM

Diabetes mellitus

eGFR

Estimated glomerular filtration rate

HbA1c

Glycosylated hemoglobin

MAC

Macrovascular complications

MIC

Microvascular complications

NPDR

Not proliferative diabetic retinopathy

PDR

Proliferative diabetic retinopathy

T1D

Type 1 diabetes

T2D

Type 2 diabetes

References

  1. 1.
    International Diabetes Federation. IDF diabetes atlas (2015) IDF http://www.diabetesatlas.org/component/attachments/?task=download&id=116
  2. 2.
    Marcellusi A, Viti R, Sciattella P et al (2016) Economic aspects in the management of diabetes in Italy. BMJ Open Diabet Res Care 4(1):e000197. https://doi.org/10.1136/bmjdrc-2016-000197 CrossRefGoogle Scholar
  3. 3.
    Yau JWY, Rogers SL, Kawasaky R et al (2012) Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 35(3):556–564CrossRefGoogle Scholar
  4. 4.
    The Emerging Risk Factors Collaboration (2010) Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective study. Lancet 375(9733):2215–2222CrossRefGoogle Scholar
  5. 5.
    Brun E, Nelson RG, Bennett PH et al (2003) Verona Diabetes Study. Diabetes duration and cause-specific mortality in the Verona Diabetes Study. Diabetes Care 23(8):1119–1123CrossRefGoogle Scholar
  6. 6.
    Jackson G, Boon N, Eardley I et al (2010) Erectile dysfunction and coronary heart disease prediction: evidence-based guidance and consensus. Int J Clin Pract 64(7):848–857CrossRefGoogle Scholar
  7. 7.
    American Diabetes Association Standard of Medical Care in Diabetes (2017) Diabet Care 40(Suppl 1):S1–S135Google Scholar
  8. 8.
    Tavakol ME, Fatemi A, Karbalaie A et al (2015) Nailfold capillaroscopy in rheumatic diseases: which parameters should be evaluated? Biomed Res Int. http://dx.doi.org/10.1155/2015/974530
  9. 9.
    Maggini M, Spila Alegiani S, Raschetti R et al (2003) Complicanze macroangiopatiche nei pazienti diabetici di tipo 2 afferenti ai Servizi di diabetologia Italiani. Ann Ist Super Sanita 39:165–171PubMedGoogle Scholar
  10. 10.
    Jellinger PS, Handelsman Y, Rosenblit PD, et al (2017) American Association of Clinical Endocrinologist and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract 23(Suppl 2):1–87CrossRefGoogle Scholar
  11. 11.
    Brenner BM, Cooper ME, de Zeeuw D et al (2001) Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Med J Med 345:861–869CrossRefGoogle Scholar
  12. 12.
    Pugliese G, Solini E, Bonora E et al (2014) Chronic kidney disease in type 2 diabetes: lessons from the renal insufficiency and cardiovascular events (RIACE) Italian Multicentre Study. Nutr Metab Cardiovasc Dis 24(8):815–822CrossRefGoogle Scholar
  13. 13.
    Cicco G, Cicco S (2007) Hemorheological aspects in microvasculature of several pathologies. Adv Exp Med Biol 599:7–15CrossRefGoogle Scholar
  14. 14.
    Barchetta I, Ricceri V, Vasile K et al (2011) High prevalence of capillary abnormalities in patients with diabetes and association with retinopathy. Diabet Med 28:1039–1044CrossRefGoogle Scholar
  15. 15.
    Uyar S, Balkarli A, Erol MK et al (2016) Assessment of the relationship of diabetic retinopathy and nailfold capillaries in type 2 diabetics with a noninvasive method: nailfold videocapillaroscopy. J Diabet Res. https://dx.doi.org/10.1155/2016/7592402

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Giuseppe Lisco
    • 1
  • Giuseppe Cicco
    • 1
  • Angelo Cignarelli
    • 1
  • Gabriella Garruti
    • 1
  • Luigi Laviola
    • 1
  • Francesco Giorgino
    • 1
  1. 1.Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ TransplantationUniversity of Bari Aldo MoroBariItaly

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