Endocrine Abstracts (2001) 2 P30


A Stifts, P Tretjakovs, A Martinsons, A Petersons, A Jurka, M Marga & V Pirags

Department of Endocrinology, P. Stradins University Hospital.

According to the hypothesis, the capillary albumin leakage parallels the degree of microalbuminuria, probably reflecting a generalized basement membrane abnormality, and relates with microvascular disfunction. The AIM of our study was to estimate postocclusive reactive hyperaemic response in patients with microalbuminuria. MATERIALS: Patients with microalbuminuria were divided into two groups: 18 patients with diabetic nephropathy (N) and 18 non-diabetic patients with glomerulonephritis (G); 20 healthy subjects were studied as controls (C). The groups were matched for age, sex and body mass index. Subjects with peripheral vascular disease, hypertension, peripheral neuropathy and dyslipidemia were excluded. METHODS: We recorded changes in the cutaneous blood flow induced by 3 min arterial occlusion on the dorsum of the big toe using laser Doppler (LD) flowmetry (PeriFlux 4001, Perimed, Sweden). The following LD indexes were calculated (PeriSoft program): basal LD flux (b-LDF); the percent increase of b-LDF as a result of hyperaemia (d-LDF; %) and time to peak LD flux (t-LDF; s). RESULTS: Basal LD flux was without significant changes (mean+/-SD; Mann-Whitney U test) among the study groups. Comparing results of hyperaemia in each patient group with controls, we found significant differences: d-LDF was decreased in both N and G groups (p<0.001 and p<0.05), the decrease of d-LDF was more pronounced in N group than in G group (N 134+/-61 vs G 188+/-52 %, p<0.05). t-LDF was prolonged in both N and G groups in comparison to the controls (p<0.01 and p<0.05). CONCLUSION: Our results suggest that patients with microalbuminuria have an impaired cutaneous vasomotor response, which may have diverse effects on the skin microvasculature, depending on diabetic nephropathy or glomerulonephritis

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