Correlation of cutaneous blood microcirculation parameters with biological age in diabetic patients

Известно, что с возрастом и при ряде хронических заболеваний происходит снижение реактивности микроциркуляторного звена кровообращения. Целью данного исследования стала оценка взаимосвязи параметров кожной микроциркуляции с биологическим и хронологическим возрастом у пациентов с сахарным диабетом. В исследование были включены 11 человек с сахарным диабетом [медиана возраста 57 (51; 64) лет]; биологический возраст определяли с помощью калькулятора Aging.AI. Показатели кожной микроциркуляции оценивали с помощью метода лазерной допплеровской флоуметрии в ходе окклюзионно-теплового теста. Для анализа взаимосвязи количественных параметров рассчитывали коэффициенты ранговой корреляции Спирмена. Были выявлены значимые множественные отрицательные корреляции биологического возраста с показателями реактивности микрососудов как при тепловом, так и при окклюзионном воздействии (сила корреляций от -0,618 до -0,97, p<0,05). У лиц с сахарным диабетом снижение реактивности микрососудов в большей мере ассоциировано с биологическим возрастом, чем с хронологическим. It has been established that the age together with the number of chronic diseases cause the decrease of the reactivity of the microcirculatory bed. This study aims to evaluate the relationship between cutaneous microcirculation parameters and biological and chronological age of patients with diabetes mellitus. 11 diabetic patients (median age 57 (51; 64) years) were examined in course of this study; biological age was figured by Aging.AI calculator. Cutaneous microcirculation parameters were measured by laser Doppler flowmetry with an occlusion-heating test. Spearman’s rank correlation coefficients were calculated to analyze the relationships between quantitative parameters. Significant multiple negative correlations of biological age and microvascular reactivity indices on exposure to both heat and occlusion (correlation strength from -0,618, to -0,97, p<0,05) were found. Diabetic patients have decreased microvascular reactivity that is more associated with biological age than with chronological age.

Abnormalities in Cutaneous Microcirculation in Patients with Alzheimer’s Disease, Mild Cognitive Impairment, and Chronic Insomnia Disorder

Impaired sympathetic response is frequently observed in neurodegenerative diseases, such as Alzheimer’s disease (AD). On the other hand, chronic insomnia disorder (CID) is also often accompanied by activation of sympathetic nerves. Considering that cutaneous microcirculation reflects sympathetic tone, we hypothesized that baseline cutaneous microcirculation in fingers, as detected by laser Doppler flowmetry (LDF), differs among patients with mild cognitive impairment (MCI), AD, and CID. As light therapy is one of the adjunctive treatments for AD and CID, we designed a randomized controlled cross-over trial of light therapy through eyes for 12 weeks with red light as treatment and green light as control limb, and examined if light therapy has an impact on cutaneous microcirculation. Before light therapy, patients with AD had significantly lower baseline cutaneous perfusion than those with CID in left and right first to fourth fingers. After red light therapy, however, cutaneous perfusion of fingers in CID patients significantly decreased (right fingers, before vs. after = 227.25 ± 62.00 vs. 162.00 ± 49.34, p = 0.007; left fingers, before vs. after = 228.99 ± 58.80 vs. 177.41 ± 59.41, p = 0.003) while cutaneous perfusion of fingers in CID patients did not significantly change after green light therapy. Light therapy with red light also significantly increased cutaneous finger perfusion in patients with AD (right fingers, before vs. after = 130.13 ± 49.82 vs. 172.38 ± 38.32, p = 0.043). Our results suggest that cutaneous perfusion is a useful tool to detect sympathetic dysfunction in patients with CID and AD, and that light therapy with red light is a potential therapeutic intervention to reverse impaired sympathetic function in patients with CID and patients with AD.

Oral Glucose Load and Human Cutaneous Microcirculation: An Insight into Flowmotion Assessed by Wavelet Transform

Microcirculation in vivo has been assessed using non-invasive technologies such as laser Doppler flowmetry (LDF). In contrast to chronic hyperglycemia, known to induce microvascular dysfunction, the effects of short-term elevations in blood glucose on microcirculation are controversial. We aimed to assess the impact of an oral glucose load (OGL) on the cutaneous microcirculation of healthy subjects, quantified by LDF and coupled with wavelet transform (WT) as an interpretation tool. On two separate occasions, sixteen subjects drank either a glucose solution (75 g in 250 mL water) or water (equal volume). LDF signals were obtained in two anatomical sites (forearm and finger pulp) before and after each load (pre-load and post-load, respectively), in resting conditions and during post-occlusive reactive hyperemia (PORH). The WT allowed decomposition of the LDF signals into their spectral components (cardiac, respiratory, myogenic, sympathetic, endothelial NO-dependent). The OGL blunted the PORH response in the forearm, which was not observed with the water load. Significant differences were found for the cardiac and sympathetic components in the glucose and water groups between the pre-load and post-load periods. These results suggest that an OGL induces a short-term subtle microvascular impairment, probably involving a modulation of the sympathetic nervous system.

The connection between changes in the cutaneous microcirculation reactivity and biological age in patients with diabetes mellitus. Pilot study

Цель: оценить корреляцию реактивности микроциркуляторного звена кровообращения с биологическим и хронологическим возрастом.

Improvement of Superficial and Deep Cutaneous Microcirculation Due to Axillary Plexus Anesthesia Impaired by Smoking

Background: Understanding microvascular physiology is key to any reconstructive procedure. Current concepts in anesthesia increasingly involve regional peripheral nerve blockade during microvascular reconstructive procedures. Whereas favorable effects on perfusion due to these techniques have been reported earlier, little evidence focusing on its effects in most peripheral vascular compartments is available. Methods: A total of 30 patients who were to receive axillary plexus blockade (APB) were included. Microcirculatory assessment of the dependent extremity was conducted utilizing combined laser-Doppler flowmetry and white light spectroscopy. Two probes (1–2 and 7–8 mm penetration depth) were used to assess changes in microcirculation. Results: APB resulted in significant changes to both superficial and deep cutaneous microcirculation. Changes in blood flow were most prominent in superficial layers with a maximum increase of +617% compared to baseline values. Significantly lower values of +292% were observed in deep measurements. Consecutively, a significant enhancement in tissue oxygen saturation was observed. Further analysis revealed a significant impairment of perfusion characteristics due to reported nicotine consumption (max Bf: +936% vs. +176%). Conclusion: Cutaneous microcirculation is strongly affected by APB, with significant differences regarding microvascular anatomy and vascular physiology. Smoking significantly diminishes the elicited improvements in perfusion. Our findings could influence reconstructive strategies as well as dependent perioperative anesthetic management.

STATE OF CUTANEOUS MICROCIRCULATION IN PATIENTS WITH OBESITY

The aim: To determine the influence of obesity on cutaneous microcirculation in patients with different stages of obesity and without cardio-vascular pathologies. Materials and methods: The 67 eligible patients with obesity were enrolled into the main group in this research. 20 healthy patients with normal body weight were included in the control group in this study. The mean age and gender were similar among the groups. Each patient underwent a clinical evaluation during the consultation, biological tests, electrocardiogram, Laser Doppler flowmetry. Results: There was a significant decrease in IM and σ in patients with class II obesity and class III obesity compared with control group. IV was decreased in all groups, but the significant differences were recorded only among patients with obesity and not among overweight patients. During wavelet analysis a significant decrease of the AmaxE was detected in all 4 groups (by 14,7%, 37,7%, 52,4%, 57,4% respectively, P < 0,05). The most significant changes were recorded in the heart spectrum (AmaxC). Conclusions: Overweight patients and patients with obesity without cardio-vascular pathology have initial manifestations of microcirculatory disorders, which deteriorate with an increase of BMI. Changes in microcirculation in patients with obesity characterized by the significant decrease of microvessels perfusion, decreasing endothelial and increasing heart specter modulations. Only high BMI was found to be associated with impaired microcirculation endothelial function (AmaxE B=0.446, 95% CI [0,15, 0,92]) according to the results of regression analysis.