Background and Aims

To evaluate intercourse of microcirculatory bed, EF parameters changes with nerves electrical activity metrics and compare them among patients with different HbA1C.

Methods

Patients (N=161) were divided into 3 groups: G1 -HbA1C<7% (N=46, men 54%, age 53.15±8.71), G2 -7≤HbA1C<9% (N=64.55% male, age 53.6±9.3), G3 -HbA1C>9%, N=51.51% males, age 53.53±8.54).

Digital capillaroscopy included capillary coiling (CC), polymorphism, network density, perivascular zone, arterial/ apex/ venous segments diameters estimation. Pulse wave velocity (PWV), endothelial function (EF) were measured by plethysmography. N.suralis, n.peroneus M-response amplitude (Mr-A), excitation propagation velocity (EPV), M-response triggering threshold (Mr-TT), residual latency were evaluated with stimulation electromyography.

Results

G2 in comparison to G1 revealed: decreased n.suralis Mr-A (p=0.04), reduced EPV (p=0.03), higher Mr-TT detection rate (p<0.01); decreased n.peroneus Mr-A (p=0.03); reduced EPV (p=0.02); increased capillary polymorphism (p=0.02), CC (p=0.06), venous/arterial segment ratio (p=0.04), increased PWV (p=0.02). Comparison between G3 and G2 also revealed statistical significance.

Microcirculatory disorders are minimally associated with diabetic polyneuropathy: direct correlation of capillary density with n.suralis EPV (p<0.05), and inverse correlation with increased n.peroneus Mr-TT (p<0.05).

The interrelation between EF and n.suralis Mr-A was determined. The correlation of PWV was revealed with: n.suralis Mr-TT and n.peroneus increase, n.peroneus low-amplitude F-waves with fallout and EPV.

Conclusions

Motor neuropathy was found more distinct than sensorial in 7≤HbA1C<9% group.

Interrelation between microvascular and neurological disorders identified minimally. Only capillary density correlated with EPV n.suralis, n.peroneus Mr-TT. Macrovascular violations (PWV increase, EF decrease) more than microvascular were associated with nerves electrical activity impairment. Interrelations between microcirculation, stimulation electromyography parameters and glucose+HbA1C were found.