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

Urbancic-Rovan, V. and Stefanovska, A. and Bernjak, A. and Azman-Juvan, K. and Kocijancic, A. (2004) Skin Blood Flow in the Upper and Lower Extremities of Diabetic Patients with and without Autonomic Neuropathy. Journal of Vascular Research, 41 (6). pp. 535-545.

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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.

Item Type: Article
Journal or Publication Title: Journal of Vascular Research
Uncontrolled Keywords: Autonomic nervous system ; Diabetic angiopathies ; Diabetic neuropathies ; Diagnostic techniques ; Cardiovascular Laser Doppler flowmetry ; Laterality ; Microcirculation ; Nonlinear dynamics ; Pulsatile flow ; Vasomotor system
Subjects: Q Science > QP Physiology
Departments: Faculty of Science and Technology > Physics
ID Code: 9301
Deposited By: Ms Margaret Calder
Deposited On: 03 Jun 2008 16:32
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 18:34
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/9301

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