Nutritive skin microcirculatory dysfunction detected in normoglycaemic subjects with metabolic syndrome

Insulin resistance and/or hyperinsulinaemia in vascular beds are associated with endothelial dysfunction, microcirculatory dysfunction (MD) and abnormal haemodynamics. This study aimed to determine whether normoglycaemic subjects with metabolic syndrome had detectable skin MD. To this end, 36 subjects with metabolic syndrome (NCEP ATP III criteria) and normal glucose tolerance as well as 16 control subjects underwent nailfold videocapillaroscopy, with the following measurements done: afferent, efferent, and apical capillary diameters; functional capillary density; baseline red blood cell velocity (RBCV); RBCV(max) and time (TRBCV(max)) to reach RBCV during postocclusive reactive hyperaemia (a nitric oxide-modulated response) after 1-minute arterial occlusion. Compared with controls, subjects with metabolic syndrome had significantly smaller afferent, efferent, and apical diameters; significantly lower functional capillary density, RBCV and RBCV(max); and significantly longer TRBCV(max), MD being associated with body mass index. In conclusion, subjects with metabolic syndrome already exhibit nutritive skin MD which develops within a normoglycaemic milieu.

Abstract

Keywords:
BMI – Microvascular disease – NCEP ATP III definition – Plasma glucose