Nailfold capillaroscopy and microvascular involvement in Diabetes Mellitus

Keywords: diabetes mellitus, microcirculation, diabetic retinopathy, microscopic angioscopy

Abstract

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/mm3 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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Author Biographies

Camila F. Lima, Mackenzie School of Medicine of Paraná; Department of Medicine, Curitiba, Paraná, Brazil.

Physician graduated from Mackenzie Evangelical School of Medicine Paraná (FEMPAR), Curitiba, PR, Brazil.

Igor H. Morais, Mackenzie School of Medicine of Paraná; Department of Medicine, Curitiba, Paraná, Brazil.

Physician graduated from Mackenzie Evangelical School of Medicine Paraná, (FEMPAR), Curitiba, PR, Brazil.

Kelvin Suckow, Mackenzie School of Medicine of Paraná; Department of Medicine, Curitiba, Paraná, Brazil.

Physician graduated from Mackenzie Evangelical School of Medicine Paraná, (FEMPAR), Curitiba, PR, Brazil.

Renato Nisihara, Mackenzie School of Medicine of Paraná; Department of Medicine, Curitiba, Paraná, Brazil.

PhD in Internal Medicine from the Federal University of Paraná (FEMPAR), Curitiba, PR, Brazil; Professor of Immunology at Mackenzie Evangelical School of Medicine Paraná (FEMPAR), Curitiba, PR, Brazil.

Thelma Skare, Mackenzie School of Medicine of Paraná; Department of Medicine, Curitiba, Paraná, Brazil.

PhD in Principles of Surgery by the Medical Research Institute of the Evangelical University Hospital of Curitiba, PR, Brazil; Professor of Rheumatology at Mackenzie Evangelical School of Medicine Paraná (FEMPAR), Curitiba, PR, Brazil.

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Published
2021-09-28
How to Cite
Lima, C. F., Morais, I. H., Suckow, K., Nisihara, R., & Skare, T. (2021). Nailfold capillaroscopy and microvascular involvement in Diabetes Mellitus. Scientia Medica, 31(1), e39679. https://doi.org/10.15448/1980-6108.2021.1.39679