BACKGROUND:Neurogenic regulation is involved in the development of microcirculation response to local heating. We suggest that microvascular reactivity can be used to estimate the severity of diabetic polyneuropathy (DPN). OBJECTIVE:To evaluate the prospects for using the parameters of skin microvascular reactivity to determine the severity of DPN. METHODS:26 patients with diabetes mellitus were included in the study (patients with retinopathy (n = 15), and without retinopathy (n = 11)). The severity of DPN was assessed using Michigan Neuropathy Screening Instrument (MNSI) and Norfolk QOL-DN (NQOLDN). Skin microcirculation was measured by laser Doppler flowmetry with local heating test. RESULTS:There were revealed moderate negative correlations between microvascular reactivity and the severity of DPN (for MNSI (Rs = –0.430), for NQOLDN (Rs = –0.396)). In patients with retinopathy, correlations were stronger than in the general group (for MNSI (Rs = –0.770) and NQOLDN (Rs = –0.636)). No such correlations were found in patients without retinopathy. CONCLUSION:Correlation of the microvascular reactivity and DPN was revealed in patients with registered structural disorders in microvessels (retinopathy). The lack of such correlation in patients without retinopathy may be explained by the intact compensatory mechanisms of microvessels without severe disorders.

中文翻译：

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糖尿病神经病变患者微血管反应性降低

背景：神经源性调节参与了对局部加热的微循环反应的发展。我们建议微血管反应性可用于估计糖尿病性多发性神经病 (DPN) 的严重程度。目的：评估使用皮肤微血管反应性参数确定DPN严重程度的前景。方法：26名糖尿病患者纳入研究（视网膜病变患者（n=15）和无视网膜病变患者（n=11））。使用密歇根神经病筛查仪 (MNSI) 和诺福克 QOL-DN (NQOLDN) 评估 DPN 的严重程度。皮肤微循环通过激光多普勒血流仪和局部加热试验进行测量。结果：微血管反应性与 DPN 的严重程度之间显示出中度负相关（对于 MNSI (Rs = –0.430)，对于 NQOLDN (Rs = –0. 396))。在视网膜病变患者中，相关性强于普通组（MNSI (Rs = –0.770) 和 NQOLDN (Rs = –0.636)）。在没有视网膜病变的患者中没有发现这种相关性。结论：微血管反应性与 DPN 的相关性在已登记的微血管结构障碍（视网膜病变）患者中得到揭示。在没有视网膜病变的患者中缺乏这种相关性可以用没有严重疾病的微血管完整的代偿机制来解释。微血管反应性和 DPN 的相关性在微血管结构紊乱（视网膜病变）患者中得到揭示。在没有视网膜病变的患者中缺乏这种相关性可以用没有严重疾病的微血管完整的代偿机制来解释。微血管反应性和 DPN 的相关性在微血管结构紊乱（视网膜病变）患者中得到揭示。在没有视网膜病变的患者中缺乏这种相关性可以用没有严重疾病的微血管完整的代偿机制来解释。