ASSESSMENT OF THE SKIN AND RETINAL MICROVASCULATURE WITH THE OPTICAL METHODS OF DIAGNOSTICS IN PATIENTS WITH DIABETES MELLITUS

Cover Page

Cite item

Abstract

Background: Abnormalities of microvasculature could be an early marker of diabetic complications. Therefore, its non-invasive assessment in diabetic patient seems highly relevant. Aim: To assess microcirculation in the skin and retina of patients with diabetes mellitus using optical diagnostic techniques: laser Doppler flowmetry (LDF) and Retinal Vessel Analyser (RVA). Materials and methods: Cutaneous microcirculation rhythms were analyzed in 18 patients with type 2 diabetes mellitus and 16 healthy volunteers in the MONIKI (Moscow, Russia). Microcirculation in the dorsal hand and foot skin was assessed by LDF for 2 minutes. The amplitude and frequencies of perfusion oscillations corresponding to the rhythms of various etiologies were computed by Waveletanalysis. Retinal vasomotions and their changes were studied in 33 type 1 diabetic patients compared to 33 healthy volunteers in the Aachen University of Applied Sciences (Germany). Original recordings made by the RVA were used for the analysis with a  Fourier transformation, cross-correlation and autocorrelation. Results: There was no significant difference in the hand skin microcirculation rhythms assessed by LDF between patients with diabetes mellitus and healthy volunteers, whereas in the lower extremities, statistically significant differences were found in the amplitude of high-frequency oscillations corresponding to the range of the heart rhythm. These results correlate well with the results of the optical assessment of retinal vasculature, where statistically significant differences in the amplitude of high frequency oscillations corresponding to the heart rate were found. In type 1 diabetic patients the periodicity of venous pulsation was higher than in the control healthy group. Conclusion: Both dynamic analysis of the pulsations and vasomotions of retinal vessels assessed by RVA and analysis of the rhythms of blood circulation in the skin of the lower extremities measured by LDF revealed a  statistically significant abnormalities of the microcirculatory dynamics in diabetic patients. The combination of these methods can be successfully applied for a  more comprehensive evaluation of the nature of microvascular abnormalities in diabetic patients and for comparison of the information obtained with clinical data.

About the authors

K. E. Kotliar

Aachen University of Applied Sciences; 11 Bayern
allee, Aachen, 52066, Germany

Author for correspondence.
Email: kotliar@fh-aachen.de
PhD (in Biol.), Professor, Faculty of Medical Engineering and Applied Mathematics Germany

A. A. Glazkov

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: kotliar@fh-aachen.de
MD, Junior Research Fellow, Medical Physics Laboratory Russian Federation

Yu. A. Kovaleva

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: kotliar@fh-aachen.de
MD, PhD, Senior Research Fellow, Department of Therapeutic Endocrinology Russian Federation

G. A. Drozdova

Peoples' Friendship University of Russia; 8 MikluhoMaklaya
ul., Moscow, 117198, Russian Federation

Email: kotliar@fh-aachen.de
MD, PhD, Professor, Chair of General Pathology and Pathophysiology, Medical Faculty Russian Federation

D. A. Kulikov

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: kotliar@fh-aachen.de
MD, PhD, Scientific Secretary Russian Federation

References

  1. International Diabetes Federation. IDF Diabetes, 7th edition. Brussels: International Diabetes Federation; 2015. Доступно на: http://www. diabetesatlas.org
  2. Koscielny J, Latza R, Wolf S, Kiesewetter H, Jung F. Early rheological and microcirculatory changes in children with type I diabetes mellitus. Clin Hemorheol Microcirc. 1998;19(2):139–50.
  3. Greenman RL, Panasyuk S, Wang X, Lyons TE, Dinh T, Longoria L, Giurini JM, Freeman J, Khaodhiar L, Veves A. Early changes in the skin microcirculation and muscle metabolism of the diabetic foot. Lancet. 2005;366(9498):1711–7. doi: http://dx.doi.org/10.1016/S0140- 6736(05)67696-9.
  4. Roustit M, Cracowski JL. Non-invasive assessment of skin microvascular function in humans: an insight into methods. Microcirculation. 2012;19(1):47–64. doi: 10.1111/j.1549- 8719.2011.00129.x.
  5. Рогаткин ДА, Лапитан ДГ, Колбас ЮЮ, Шумский ВИ. Индивидуальная вариабельность параметров микроциркуляции крови и проблемы функциональной диагностики системы микроциркуляции. Функциональная диагностика. 2012;(4):24–9.
  6. Allen J, Howell K. Microvascular imaging: techniques and opportunities for clinical physiological measurements. Physiol Meas. 2014;35(7):R91–R141. doi: 10.1088/0967- 3334/35/7/R91.
  7. Verma A, Raman R, Vaitheeswaran K, Pal SS, Laxmi G, Gupta M, Shekar SC, Sharma T. Does neuronal damage precede vascular damage in subjects with type 2 diabetes mellitus and having no clinical diabetic retinopathy? Ophthalmic Res. 2012;47(4):202–7. doi: 10.1159/000333220.
  8. Котляр К, Дроздова Г. Гемодинамика глаза и современные методы ее исследования. Часть III. Неинвазивные методы исследования кровообращения глаза. 3. Регистрация пульсовых колебаний, оксиметрия и новейшие методики в стадии разработки. Глаукома. 2007;(3):49–59.
  9. Крупаткин А, Сидоров В. Функциональная диагностика состояния микроциркуляторно-тканевых систем: колебания, информация, нелинейность: руководство для врачей. М.: Либроком; 2014. 498 c.
  10. Bek T, Jeppesen P, Kanters JK. Spontaneous high frequency diameter oscillations of larger retinal arterioles are reduced in type 2 diabetes mellitus. Invest Ophthalmol Vis Sci. 2013;54(1):636–40. doi: 10.1167/iovs.12- 11182.
  11. Au M, Rattigan S. Barriers to the management of Diabetes Mellitus – is there a future role for Laser Doppler Flowmetry? Australas Med J. 2012;5(12):627–32. doi: 10.4066/ AMJ.2012.1526.
  12. Береговский ВБ, Карпова ИА, Алексеева ЕС. Нарушения кожной микроциркуляции в нижних конечностях при сахарном диабете: патофизиологический феномен или объект для лечения? Сахарный диабет. 2011;(3):49–53.

Copyright (c) 2016 Kotliar K.E., Glazkov A.A., Kovaleva Y.A., Drozdova G.A., Kulikov D.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies