Capilaroscopia de leito ungueal e envolvimento microvascular em Diabetes Mellitus

Autores

DOI:

https://doi.org/10.15448/1980-6108.2021.1.39679

Palavras-chave:

diabetes mellitus, microcirculação, retinopatia diabética, angioscopia microscópica

Resumo

Objetivo: estudar a relação entre lesões microvasculares do Diabetes Mellitus e alterações na capilaroscopia ungueal.
Sujeitos e Métodos: estudo transversal incluindo 140 indivíduos (70 com Diabetes Mellitus e 70 controles). Variáveis epidemiológicas e clínicas foram coletadas dos prontuários dos pacientes. A oftalmoscopia de fundo, capilaroscopia ungueal, análise de microalbuminúria e depuração renal, bem como glicemia de jejum e valores de HbA1c foram estudados simultaneamente.
Resultados: a densidade capilar foi reduzida e a dilatação vascular aumentada em pacientes com Diabetes Mellitus quando comparados aos controles (ambos com p <0,0001). Em indivíduos diabéticos, o número de capilares papilares dérmicos/ mm3 correlacionou-se negativamente com microalbuminúria (p = 0,02), idade do paciente (p = 0,03), valores de HbA1c (p = 0,03). Pacientes com retinopatia diabética e em uso de antiagregante plaquetário apresentaram menor densidade capilar (p <0,0001 e 0,04 respectivamente). A dilatação capilar foi associada ao tempo de doença (p = 0,04).
Conclusão: a doença microvascular no Diabetes Mellitus reflete-se na capilaroscopia ungueal. Diminuição da densidade capilar, aumento do número de ectasias e aumento da presença de áreas avasculares foram
observados em pacientes com diabetes quando comparados aos controles. No presente estudo, a densidade capilar se correlacionou/ se associou com idade, retinopatia, uso de antiagregante plaquetário, HbA1c, microalbuminúria e tempo de diabetes. Ectasias ou dilatações foram relacionadas à retinopatia, à taxa de filtração glomerular e a maior duração da doença.

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Biografia do Autor

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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Publicado

2021-09-28

Como Citar

Lima, C. F., Morais, I. H., Suckow, K., Nisihara, R., & Skare, T. (2021). Capilaroscopia de leito ungueal e envolvimento microvascular em Diabetes Mellitus. Scientia Medica, 31(1), e39679. https://doi.org/10.15448/1980-6108.2021.1.39679

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