Macro- and microcirculation in the lower extremities—Possible relationship

• Published in: Diabetes research and clinical practice Vol. 73; no. 2; pp. 166 - 173
• Main Authors: Urbančič-Rovan, Vilma, Bernjak, Alan, Stefanovska, Aneta, Ažman-Juvan, Katja, Kocijančič, Andreja
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.08.2006
• Subjects: Aged; Blood Pressure - physiology; Blood Pressure Determination; Diabetes Mellitus - physiopathology; Diabetic angiopathies; Diabetic Foot - etiology; Endothelium; Female; Humans; Laser Doppler flowmetry; Leg - blood supply; Lower Extremity - blood supply; Male; Microcirculation; Microcirculation - physiopathology; Middle Aged; Non-linear dynamics; Peripheral Vascular Diseases - physiopathology; Regional Blood Flow - physiology; Skin - blood supply; AA; Laser Doppler flowmetry; NP; ACE; C; PAOD; D; Non-linear dynamics; ABI; BSBF; DP; AP; LDF; Endothelium; DAN; Diabetic angiopathies; Microcirculation; NA
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2006.01.002

Impaired blood supply is a significant risk factor for diabetic foot ulceration and gangrene. A possible relationship between peripheral macroangiopathy and the spectral components of microvascular skin blood flow in the lower extremities was tested in diabetic patients (DP) and non-diabetic subjects (C). Basal skin blood flow (BSBF) was recorded for 30 min at the right and left medial malleolus (predominantly nutritive capillary circulation) by laser Doppler flowmetry in 64 DP and 31 C. Its oscillatory components were analyzed using wavelet transform. Peripheral arterial obliterative disease (PAOD) was defined according to ankle/brachial index (ABI): PAOD+ (ABI < 0.9: 21 DP, 12 C), PAOD− (ABI 0.91–1.3: 43 DP, 19 C). No statistically significant differences in BSBF and its oscillatory components were observed between PAOD+ and PAOD−, neither in DP nor in C. In DP, the spectral component of microvascular flow associated with endothelial activity was in significant positive correlation with systolic pressures on brachial and dorsal pedal artery ( p = 0.001 and 0.010, respectively). These results indicate that mean BSBF and its oscillatory components do not change with diabetic PAOD; however there is a strong correlation between systolic pressure and the oscillatory components of BSBF related to endothelial activity manifested in the frequency interval 0.0095–0.02 Hz.