5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY
Background: Glycocalyx is a glycoprotein layer protecting the capillary endothelium. An impaired glycocalyx may precede the development of microvascular complications in diabetes. Capillaroscopy is a new method to estimate the dimensions of the glycocalyx by measuring the perfused boundary region (P...
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125930219/view |
| _version_ | 1818572318712004608 |
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| author | Signe Abitz Winther |
| author_facet | Signe Abitz Winther |
| author_sort | Signe Abitz Winther |
| collection | DOAJ |
| description | Background: Glycocalyx is a glycoprotein layer protecting the capillary endothelium. An impaired glycocalyx may precede the development of microvascular complications in diabetes. Capillaroscopy is a new method to estimate the dimensions of the glycocalyx by measuring the perfused boundary region (PBR). We evaluated the glycocalyx thickness in type 1 diabetic patients with different levels of historical and current albuminuria.
Methods: Cross-sectional study including 77 type 1 diabetics stratified by history of normoalbuminuria (<30 mg/g; n = 26), microalbuminuria (30–299 mg/g; n = 27) and macroalbuminuria (>300 mg/g; n = 24).
Glycocalyx thickness was assessed by 5 measurements with the GlycoCheck® device, a non-invasive hand-held microscope generating video recordings of the sublingual capillaries. Endothelial glycocalyx thickness was estimated from the PBR in capillaries with a diameter range of 5–25 μm. Higher PBR indicates smaller glycocalyx width. Urinary albumin-to-creatinine ratio (UACR) was measured in 3 morning samples.
Results: In normo-, micro-, and macroalbuminurics PBR was (mean ± SD) 2.30 ± 0.22 μm, 2.32 ± 0.25 μm, and 2.49 ± 0.35 μm, respectively. Differences between normo- and macroalbuminurics and micro- and macroalbuminurics were significant (p < 0.05) in an unadjusted model and remained significant after adjustment for age, sex, HbA1c, diabetes duration and systolic blood pressure. In pooled (n = 77) multivariate linear regression, higher level of current UACR was associated with a higher PBR (p = 0.0007).
Conclusion: In type 1 diabetics with a history of macroalbuminuria, measurements with the non-invasive GlycoCheck® device revealed significantly higher PBR, suggesting an impaired glycocalyx, compared to patients with normo- or microalbuminuria.
Moreover, higher current level of albuminuria was associated with higher PBR. |
| first_indexed | 2024-12-14T18:55:32Z |
| format | Article |
| id | doaj.art-583be7e0a90842cfb844535a8204b47c |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-12-14T18:55:32Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-583be7e0a90842cfb844535a8204b47c2022-12-21T22:51:06ZengBMCArtery Research1876-44012017-12-012010.1016/j.artres.2017.10.0485.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHYSigne Abitz WintherBackground: Glycocalyx is a glycoprotein layer protecting the capillary endothelium. An impaired glycocalyx may precede the development of microvascular complications in diabetes. Capillaroscopy is a new method to estimate the dimensions of the glycocalyx by measuring the perfused boundary region (PBR). We evaluated the glycocalyx thickness in type 1 diabetic patients with different levels of historical and current albuminuria. Methods: Cross-sectional study including 77 type 1 diabetics stratified by history of normoalbuminuria (<30 mg/g; n = 26), microalbuminuria (30–299 mg/g; n = 27) and macroalbuminuria (>300 mg/g; n = 24). Glycocalyx thickness was assessed by 5 measurements with the GlycoCheck® device, a non-invasive hand-held microscope generating video recordings of the sublingual capillaries. Endothelial glycocalyx thickness was estimated from the PBR in capillaries with a diameter range of 5–25 μm. Higher PBR indicates smaller glycocalyx width. Urinary albumin-to-creatinine ratio (UACR) was measured in 3 morning samples. Results: In normo-, micro-, and macroalbuminurics PBR was (mean ± SD) 2.30 ± 0.22 μm, 2.32 ± 0.25 μm, and 2.49 ± 0.35 μm, respectively. Differences between normo- and macroalbuminurics and micro- and macroalbuminurics were significant (p < 0.05) in an unadjusted model and remained significant after adjustment for age, sex, HbA1c, diabetes duration and systolic blood pressure. In pooled (n = 77) multivariate linear regression, higher level of current UACR was associated with a higher PBR (p = 0.0007). Conclusion: In type 1 diabetics with a history of macroalbuminuria, measurements with the non-invasive GlycoCheck® device revealed significantly higher PBR, suggesting an impaired glycocalyx, compared to patients with normo- or microalbuminuria. Moreover, higher current level of albuminuria was associated with higher PBR.https://www.atlantis-press.com/article/125930219/view |
| spellingShingle | Signe Abitz Winther 5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY Artery Research |
| title | 5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY |
| title_full | 5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY |
| title_fullStr | 5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY |
| title_full_unstemmed | 5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY |
| title_short | 5.2 REDUCED SUBLINGUAL ENDOTHELIAL GLYCOCALYX IN TYPE 1 DIABETICS WITH DIABETIC NEPHROPATHY |
| title_sort | 5 2 reduced sublingual endothelial glycocalyx in type 1 diabetics with diabetic nephropathy |
| url | https://www.atlantis-press.com/article/125930219/view |
| work_keys_str_mv | AT signeabitzwinther 52reducedsublingualendothelialglycocalyxintype1diabeticswithdiabeticnephropathy |