Skin Blood Flow in the Upper and Lower Extremities of Diabetic Patients with and without Autonomic Neuropathy

Vol. 41, No. 6, 2004

Free Abstract Article (Fulltext) Article (PDF 173 KB)

Research Paper

Skin Blood Flow in the Upper and Lower Extremities of Diabetic Patients with and without Autonomic Neuropathy
V. Urbani-Rovan^a, A. Stefanovska^b, A. Bernjak^b, K. Aman-Juvan^c, A. Kocijani^a

^aUniversity Medical Centre, Department of Endocrinology, Diabetes and Metabolic Diseases, Ljubljana,
^bUniversity of Ljubljana, Group of Nonlinear Dynamics, Faculty of Electrical Engineering, and
^cUniversity Medical Centre, Department of Intensive Internal Medicine, Ljubljana, Slovenia

Address of Corresponding Author

J Vasc Res 2004;41:535-545 (DOI: 10.1159/000081810)

Key Words

Autonomic nervous system
Diabetic angiopathies
Diabetic neuropathies
Diagnostic techniques
Cardiovascular
Laser Doppler flowmetry
Laterality
Microcirculation
Nonlinear dynamics
Pulsatile flow
Vasomotor system

Abstract

Background: Microvascular blood flow in the human skin is subject to rhythmic variations reflecting the influence of heartbeat, respiration, intrinsic myogenic activity, neurogenic factors and endothelial activity. The aim of our study was to test the hypothesis that basal skin blood flow (BSBF) and its dynamic components differ (1) among diabetic patients without autonomic neuropathy and with it and healthy control subjects, and (2) among the upper and lower extremities. Patients and Methods: BSBF at four recording sites with predominantly nutritive capillary circulation (right and left caput ulnae, right and left medial malleolus) was measured by laser Doppler flowmetry in 25 diabetic patients without cardiovascular autonomic neuropathy (D), 18 neuropathic diabetic patients (DAN) and 36 healthy controls (C). Wavelet transform was applied to the laser Doppler signal. Results: In absolute terms, mean flow, mean amplitude of the total spectrum and mean amplitudes at all frequency intervals were highest in C, followed by DAN and lowest in D. However, these differences were statistically significant only in the left arm. Within all three groups, mean flow and spectral amplitudes were significantly higher in the arms than in the legs, besides there was a significant difference between the two arms in D. Conclusion: We have confirmed the differences in BSBF among D, DAN and C, and demonstrated differences among the four recording sites which have not been previously described. The latter indicates an uneven progression of autonomic neuropathy and allows for speculation that the left arm is the latest to be affected.

Author Contacts

Vilma Urban ccaron i ccaron -Rovan, MD, MSc
Department of Endocrinology, Diabetes and Metabolic Diseases
University Medical Centre, Zaloška 7
SI-1525 Ljubljana (Slovenia)
Tel/Fax +386 1 522 27 38, E-Mail vilma.urbancic@kclj.si

Article Information

Received: April 7, 2004
Accepted after revision: September 2, 2004
Published online: October 28, 2004
Number of Print Pages : 11
Number of Figures : 3, Number of Tables : 4, Number of References : 59

Medline Abstract (ID 15528936)

Download Citation

Cited In

This journal is part of the second subject package of the Karger

Journal Archive Collection

Information on packages (PDF)
Free sample issues

For non-native English speakers and international authors who would like assistance with their writing before submission, we suggest American Journal Experts for their scientific editing service.