MYOGENIC MICROVASCULAR RESPONSES ARE IMPAIRED IN LONG-DURATION TYPE-1 DIABETES

被引：11

作者：

WALMSLEY, D

WILES, PG

机构：

[1] University Department of Medicine, General Infirmary, Leeds

来源：

DIABETIC MEDICINE | 1990年 / 7卷 / 03期

关键词：

Angiopathy; Hyperaemia; Ischaemia; Laser Doppler flowmeter; Neuropathy; Type; 1; diabetes;

D O I：

10.1111/j.1464-5491.1990.tb01374.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Post‐ischaemic hyperaemia is a complex physiological response. Peak flow is predominantly an arteriolar myogenic response, whilst viscoelasticity of supplying arteries determines speed of vasodilatation. Impaired post‐ischaemic hyperaemia has been described in neuropathic diabetic feet and might predispose to ulceration. However, the relationships of myogenic response and vasodilatation to diabetic control and microvascular complications are unclear. These relationships were therefore investigated using laser Doppler flowmetry to measure the hyperaemic response on the dorsum of the foot after 10 min ischaemia. Twenty control subjects were compared with 55 long‐duration Type 1 diabetic patients in groups of uncomplicated, retinopathic and neuropathic patients. Peak flow (median (interquartile range)) was reduced from 1.40 (1.20–1.61) in control subjects to 1.15 (0.80–1.29), 1.08 (0.75–1.26), and 0.95 (0.62–1.29) arbitrary units in the diabetic groups respectively (p = 0.012–0.004). Time to half peak flow was shorter in neuropathic diabetic patients compared with all other groups: 9.5 (7–19), 14.5 (5–25), 12.5 (6–20), and 4 (3–6) s, respectively (p = 0.027–0.011). Neuropathic patients also had the steepest initial slope of vasodilatation. Thus, in long‐duration diabetic patients, the myogenic peak post‐ischaemic hyperaemic response is impaired, but this impairment is not specifically associated with microvascular complications and was not related to recent blood glucose control. The shortened time to half peak flow and rapid vasodilatation in neuropathic patients is likely to reflect increased rigidity of their arteries. 1990 Diabetes UK

引用

页码：222 / 227

页数：6

共 44 条

[1]

Bayliss WM., On the local reactions of the arterial wall to changes of internal pressure, The Journal of Physiology, 28, pp. 220-231, (1902)

[2]

Carlsson I., Sollevi A., Wennmalm A., The role of myogenic relaxation, adenosine and prostaglandins in human forearm reactive hyperaemia, J Physiol, 389, pp. 147-161, (1987)

[3]

Jageneau A., Loots W., Brugmans J., Horig C., Hermans C., Van Loon J., Reactive hyperaemia after arterial occlusion and physical exercise, Noninvasive Methods on Cardiovascular Haemodynamics, pp. 457-468, (1981)

[4]

Meininger GA., Responses of sequentially branching macro‐ and microvessels during reactive hyperaemia in skeletal muscle, Microvasc Res, 34, pp. 29-45, (1987)

[5]

Eichna LW, Wilkins RW., Blood flow to the forearm and calf II. Reactive hyperaemia: Factors influencing the blood flow during the vasodilatation following ischaemia, Bull Johns Hopkins Hosp, 68, pp. 450-476, (1941)

[6]

Wilkin JK., Cutaneous reactive hyperemia: viscoelasticity determines response, J Invest Dermatol, 89, pp. 197-200, (1987)

[7]

Christensen NJ., Spontaneous variations in resting blood flow, postischaemic peak flow and vibratory perception in the feet of diabetics, Diabetologia, 5, pp. 171-178, (1969)

[8]

Tooke JE, Lins P-E, Ostergren J., Fagrell B., Skin microvascular autoregulatory responses in type 1 diabetes: the influence of duration and control, Int J Microcirc: Clin Exp, 4, pp. 249-256, (1985)

[9]

Jorgensen RG, Russo L., Mattioli L., Moore WV., Early detection of vascular dysfunction in type 1 diabetes, Diabetes, 37, pp. 292-296, (1988)

[10]

Christensen NJ., A reversible vascular abnormality associated with diabetic ketosis, Clin Sci, 39, pp. 539-548, (1970)

← 1 2 3 4 5 →