Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Examination of Lower Limb Microcirculation in Diabetic Patients With and Without Intermittent Claudication

Katalin Biró
* ,
Barbara Sándor
ORCID logo ,
Kinga Tótsimon
,
Katalin Koltai
,
Krisztina Fendrik
,
Dóra Endrei
ORCID logo ,
Judit Vekasi
,
Kalman Toth
ORCID logo ,
Gábor Késmárky
ORCID logo
Version 1 : Received: 30 May 2023 / Approved: 1 June 2023 / Online: 1 June 2023 (02:41:38 CEST)

A peer-reviewed article of this Preprint also exists.

Biró, K.; Sándor, B.; Tótsimon, K.; Koltai, K.; Fendrik, K.; Endrei, D.; Vékási, J.; Tóth, K.; Késmárky, G. Examination of Lower Limb Microcirculation in Diabetic Patients with and without Intermittent Claudication. Biomedicines 2023, 11, 2181. Biró, K.; Sándor, B.; Tótsimon, K.; Koltai, K.; Fendrik, K.; Endrei, D.; Vékási, J.; Tóth, K.; Késmárky, G. Examination of Lower Limb Microcirculation in Diabetic Patients with and without Intermittent Claudication. Biomedicines 2023, 11, 2181.

Abstract

Background: Intermittent claudication is a frequent complaint in lower extremity artery disease, but approximately two thirds of patients are asymptomatic, mostly in diabetic population. Non-invasive angiological and microrheological tests among diabetic patients with and without intermittent claudication were studied. Methods: 98 diabetic patients were included and divided into two groups: 20 patients (63.5±8.8 yrs, 55% men, 45% women) had intermittent claudication, 78 patients (65.5±9.3 yrs, 61.5% men, 38.5% women) were asymptomatic. Hand-held Doppler, transcutaneous tissue partial oxygen pressure (tcpO2) measurement, tuning fork test and 6-minute walk test were performed and erythrocyte aggregation was investigated. Results: Ankle/brachial index (p<0.02), and tcpO2 measured during provocational tests (p<0.003), 6-minute walk test (p<0.0001) were significantly deteriorated in the symptomatic group. Higher erythrocyte aggregation index and faster aggregate formation could be observed among claudicant patients (p<0.02). In spite of the statistically better results of the asymptomatic group, 13% of these patients had severe limb ischemia based on the result of tcpO2 measurement. Conclusion: Claudication could be associated with worse hemodynamical and hemorheological status in diabetics; nevertheless, severe ischemia can develop even in asymptomatic subjects which can be revealed by noninvasive vascular tests, which highlights the importance of the early instrumental screening of the lower limbs.

Keywords

diabetes mellitus; lower extremity artery disease; red blood cell aggregation, transcutaneous partial tissue oxygen pressure

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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