Nailfold capillaroscopy in diabetes mellitus

Microvasc Res. 2017 Jul:112:41-46. doi: 10.1016/j.mvr.2017.03.001. Epub 2017 Mar 6.

Abstract

Introduction: Diabetes mellitus (DM) is characterized by chronic hyperglycemia states and the development of specific microvascular disorders such as retinopathy and nephropathy. Conventional methods are used to study the vascular compromise of this entity, however, the use of capillaroscopy for the evaluation of capillary microarchitecture is not frequently used.

Methods and materials: Observational and descriptive study of 65 patients with an established diagnosis of DM and a control group that underwent an initial capillaroscopy examination. The parameters considered were: Capillary diameter (ectasia and giant capillaries), cross-linked, tortuous, arborified capillaries, avascular zones, haemorrhages, dominant morphology, visibility of the subpapillary venous plexus (SPVP), cuticulitis and SD pattern.

Results: Capillaroscopy was performed in 65 patients, the findings were: tortous capillaries (63%), crosslinked capillaries (59%), avascular areas (48%), ectasias (39%), giant capillaries (11%). The capillaroscopic findings were evident in the majority of the studied population, 83%, compared to 17% who did not have capillaroscopic alterations.

Conclusion: Significant capillaroscopic changes were demonstrated in patients with DM, in turn, we described a specific pattern consisting of: capillary dilatation, avascular zones and tortuous capillaries. Patients with more comorbidities and evolution of the disease showed greater microvascular damage.

Keywords: Comorbidities; Diabetes mellitus; Nailfold capillaroscopy; Retinopathy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Capillaries / pathology*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetic Angiopathies / diagnosis*
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / pathology
  • Dilatation, Pathologic
  • Female
  • Humans
  • Male
  • Microscopic Angioscopy*
  • Middle Aged
  • Nails / blood supply*
  • Predictive Value of Tests
  • Prognosis
  • Severity of Illness Index