Lower limb ischemia and microrheological alterations in patients with diabetic retinopathy

Issue title: Special Issue in Honour of the Editor-in-Chief Prof. Dr. Ing. Friedrich Jung on his 70th Birthday

Article type: Research Article

Authors: Biro, Katalin^a | Sandor, Barbara^a | Kovacs, David^a | Csiszar, Beata^a | Vekasi, Judit^b | Totsimon, Kinga^a | Toth, Andras^c | Koltai, Katalin^a | Endrei, Dora^a | Toth, Kalman^a | Kesmarky, Gabor^{a; *}

Affiliations: [a] First Department of Medicine, University of Pecs, Medical School, Hungary | [b] Department of Ophthalmology, University of Pecs, Medical School, Hungary | [c] Department of Radiology, University of Pecs, Medical School, Hungary

Correspondence: [*] Corresponding author: Gabor Kesmarky, M.D., Ph.D., First Department of Medicine, Medical School, University of Pecs, Ifjusag ut 13, H-7624 Pecs, Hungary. Tel.: +36 204454743; E-mail: kesmarky.gabor@pte.hu.

Abstract: BACKGROUND:Diabetes mellitus is frequently associated with vascular pathologies and hemorheological disorders. METHODS:105 patients with diabetic retinopathy (DRP) (mean age 64.64±9.01 years, 56 males, 49 females), 35 age-matched non-diabetic (mean age 61.65±7.6 years, 14 males and 21 females) and 42 young healthy volunteers (mean age 25.52±3.32 years, 22 males, 20 females) were recruited. Lower extremity artery disease (LEAD) and microcirculatory alterations were screened by hand-held Doppler, transcutaneous partial tissue oxygen tension (tcpO2), tuning fork test, 6-minute walk test, erythrocyte aggregation and deformability. RESULTS:High prevalence of LEAD was detected in diabetic population: 55.3% fulfilled the criteria of LEAD based on ankle-brachial index; severely impaired tcpO2 was measured in 18.6%. The results of non-invasive measurements of the diabetic patients were significantly worse than those of the control groups (p < 0.05). Hemorheological disturbances could be characterized by the significantly higher erythrocyte aggregation (p < 0.05) and lower erythrocyte deformability (p < 0.05) in the diabetic population. CONCLUSION:Macro- and microcirculatory lower limb disorders could be revealed at high prevalence in diabetic patients with retinopathy. Measurement of tcpO2 and hemorheological variables could be useful to discover patients at higher risk for diabetic foot complications.

Keywords: Diabetes mellitus, transcutaneous partial tissue oxygen pressure, red blood cell aggregation, red blood cell deformability, peripheral arterial disease

DOI: 10.3233/CH-189103

Journal: Clinical Hemorheology and Microcirculation, vol. 69, no. 1-2, pp. 23-35, 2018