(Open access funding provided by University of Debrecen)
(GINOP-2.1.1-15-2015-00609)
(TKP2021-NKTA-34)
(TKP2021-NKTA)
Szakterületek:
Klinikai orvostan
Orvos- és egészségtudomány
In order to investigate microvascular complications in metabolic diseases, we aimed
to investigate cerebral and peripheral microcirculation in relation to peripheral
neuropathy and laboratory biomarkers in type 2 diabetes mellitus (T2DM) and obesity.Based
on the degree of neuropathy (NP), study participants (40 T2DM and 30 obese individuals)
were classified into no-NP, mild-NP and severe-NP subgroups. After the injection of
Technetium-99 m hexamethylpropylene amine oxime, both T2DM and obese participants
underwent single-photon emission computed tomography/computed tomography ([99mTc]Tc-HMPAO
SPECT/CT) and SPECT-only examinations to assess lower limb and brain perfusion; respectively.
Peripheral nerve function was evaluated with a neurometer and glycaemic markers were
measured from plasma in both groups.Compared to the obese individuals, lower extremity
perfusion was significantly reduced in the diabetic subjects (p < 0.005), while it
showed a positive correlation with C-peptide levels and negative association with
HbA1c values. A U-shape pattern of peripheral microcirculation was observed between
the NP groups, indicating a surprisingly better perfusion in the severe-NP group than
in the mild one, with the highest levels in obese patients. Since changes in the C-peptide
levels exhibited a similar U-shaped trend across the NP subgroups, we suggest a positive
correlation between C-peptide levels and the extent of peripheral perfusion. Although,
C-peptide values and cerebral microcirculation correlated positively (rho = 0.27),
brain perfusion did not show any differences neither between the diabetic and the
obese patients, nor between the NP subgroups (at p < 0.05).Establishing the link between
neuropathy and peripheral microcirculation, C-peptide seems to be a promising biomarker
for the prediction of microvascular alterations in metabolic diseases. Of note, the
dominance of metabolic factors over microvascular damage in the development of obesity-related
neuropathy should be emphasized as well.
