TY - JOUR
T1 - Skin microvascular function and renal hemodynamics in overweight patients with type 2 diabetes: A cross-sectional study
AU - Bouman, Emma J.
AU - Smits, Mark M.
AU - van Bommel, Erik J.
AU - Muskiet, Marcel H. A.
AU - Hesp, Anne C.
AU - Serné, Erik H.
AU - Joles, Jaap A.
AU - van Raalte, Daniël H.
N1 - Funding Information: DVR is supported by a research fellowship from the Dutch Diabetes Foundation and EU Marie Curie program. SAFEGUARD was funded by the European Community's Seventh Framework Programme (FP7/2007-2013) (under grant agreement 282521, the SAFEGUARD project) and the Dutch Kidney Foundation (under grant agreement IP12.87). The RENALIS trial was an investigator-initiated trial sponsored by Boehringer Ingelheim. The RED trial was an investigator-initiated trial sponsored by Astra Zeneca The authors were fully responsible for all content and editorial decisions and were involved at all stages of manuscript development and have approved the final version. Funding Information: DVR is supported by a research fellowship from the Dutch Diabetes Foundation and EU Marie Curie program. SAFEGUARD was funded by the European Community's Seventh Framework Programme (FP7/2007‐2013) (under grant agreement 282521, the SAFEGUARD project) and the Dutch Kidney Foundation (under grant agreement IP12.87). The RENALIS trial was an investigator‐initiated trial sponsored by Boehringer Ingelheim. The RED trial was an investigator‐initiated trial sponsored by Astra Zeneca Publisher Copyright: © 2021 The Authors. Microcirculation published by John Wiley & Sons Ltd.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Objective: Diabetic kidney disease is a microvascular complication of diabetes. Here, we assessed the association between skin microvascular function and renal hemodynamic function in a cohort of well-phenotyped adults with type 2 diabetes (T2D). Methods: We included 81 overweight/obese adults (age: 62 ± 8 years; BMI: 32 ± 4 kg/m2) with well-controlled T2D and no renal impairment. Skin microvascular function was assessed by nailfold capillary density in rest and after arterial occlusion (ie, peak capillary density). Renal hemodynamic functions (ie, measured glomerular filtration rate [mGFR], effective renal blood flow [ERBF], filtration fraction [FF], and effective renal vascular resistance [ERVR]) were assessed by combined inulin and para-aminohippurate clearances and blood pressure measurements. Results: Skin capillary density was 45 ± 10 capillaries/mm2 at baseline and 57 ± 11 capillaries/mm2 during post-occlusive peak; mGFR averaged 108 ± 20 ml/min. In multivariable regression analyses, positive associations between capillary density during post-occlusive peak and mGFR (β = 0.224; p = 0.022) and ERBF (β = 0.203; p = 0.020) and a positive trend for hyperemia and mGFR (β = 0.391; p = 0.053) were observed, while a negative association for post-occlusive capillary density with ERVR (β = −0.196; p = 0.027) was found. Conclusion: These findings indicate that microvascular dysfunction in overweight adults with T2D is associated with lower mGFR and ERPF and higher ERVR. We hypothesize that increased renal vascular resistance may contribute to glomerular dysfunction due to impaired renal perfusion.
AB - Objective: Diabetic kidney disease is a microvascular complication of diabetes. Here, we assessed the association between skin microvascular function and renal hemodynamic function in a cohort of well-phenotyped adults with type 2 diabetes (T2D). Methods: We included 81 overweight/obese adults (age: 62 ± 8 years; BMI: 32 ± 4 kg/m2) with well-controlled T2D and no renal impairment. Skin microvascular function was assessed by nailfold capillary density in rest and after arterial occlusion (ie, peak capillary density). Renal hemodynamic functions (ie, measured glomerular filtration rate [mGFR], effective renal blood flow [ERBF], filtration fraction [FF], and effective renal vascular resistance [ERVR]) were assessed by combined inulin and para-aminohippurate clearances and blood pressure measurements. Results: Skin capillary density was 45 ± 10 capillaries/mm2 at baseline and 57 ± 11 capillaries/mm2 during post-occlusive peak; mGFR averaged 108 ± 20 ml/min. In multivariable regression analyses, positive associations between capillary density during post-occlusive peak and mGFR (β = 0.224; p = 0.022) and ERBF (β = 0.203; p = 0.020) and a positive trend for hyperemia and mGFR (β = 0.391; p = 0.053) were observed, while a negative association for post-occlusive capillary density with ERVR (β = −0.196; p = 0.027) was found. Conclusion: These findings indicate that microvascular dysfunction in overweight adults with T2D is associated with lower mGFR and ERPF and higher ERVR. We hypothesize that increased renal vascular resistance may contribute to glomerular dysfunction due to impaired renal perfusion.
KW - capillary recruitment
KW - diabetic kidney disease
KW - measured GFR
KW - microvascular dysfunction
KW - renal hemodynamics
KW - type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85109449883&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/micc.12700
DO - https://doi.org/10.1111/micc.12700
M3 - Article
C2 - 33864418
SN - 1073-9688
VL - 28
JO - Microcirculation (New York, N.Y.
JF - Microcirculation (New York, N.Y.
IS - 6
M1 - e12700
ER -