Association Between Nailfold Capillary Abnormalities and Diabetic Nephropathy in Type 2 Diabetes

Presentation Number: SAT 521
Date of Presentation: April 1st, 2017

Hyeong Kyu Park*, Mi Kyung Kwak, Hyun Suk Kim, Hye Jeong Kim, Dong Won Byun and Kyo-Il Suh
Soonchunhyang University Hospital, Seoul, Korea, Republic of (South)

Abstract

Several capillary changes detected by finger nailfold capillaroscopy have been shown to correlate with microvascular complications in type 1 diabetes. However, there are few reports on the relationship between nailfold capillary abnormalities and microvascular complications in type 2 diabetes (T2DM). Herein, we investigated whether nailfold capillary microscopic changes are associated with diabetic nephropathy in patients with T2DM.

We conducted a cross-sectional study in patients with T2DM diagnosed within 20 years (duration of diabetes: 6.4 ± 6.0 years). The nailfold capillaroscopy test is non-invasive and able to visualize the capillary network in fingers. The presence of morphological abnormalities, including avascular areas, giant capillaries, dilated, tortuous, or ramified capillaries, hemorrhages and capillary architectural derangements, in finger nailfold capillaroscopy image was assessed by a single rheumatology specialist. The severity of nailfold capillary changes was scored. Statistical analyses were performed using Pearson correlation or Spearman rank correlation as appropriate.

A total of 63 patients with T2DM were enrolled. Both capillary architectural derangements and avascular areas in nailfold capillaroscopy showed significant correlations with albuminuria measured by spot urine or 24-hour urine collection after adjusting for sex, age, body mass index, duration of diabetes, hemoglobin, and HbA1C. Moreover, architectural derangements and avascular areas in nailfold capillaries were significantly associated with urinary albumin excretion rate in T2DM patients diagnosed within 10 years.

Taken together, nailfold capillary abnormalities are independently associated with albuminuria in patients with T2DM. These findings suggest a potential role of capillary changes in the pathogenesis of diabetic nephropathy.

 

Nothing to Disclose: HKP, MKK, HSK, HJK, DWB, KIS