Background: The glycocalyx lines the inner surface of the capillary endothelium. Capillaroscopy enables visualization of the sublingual capillaries and measurement of the perfused boundary region (PBR) as an estimate of the glycocalyx. Novel software enables assessment of the PBR estimated at a fixed high flow level (PBR-hf) and the microvascularity by the MicroVascular Health Score (MVHS). Damaged glycocalyx may represent microvascular damage in diabetes and assessment of its dimension might improve early cardiovascular (CV) risk stratification.
Aim: To assess the associations between PBR, PBR-hf and MVHS and CV risk factors in persons with type 1 diabetes (T1D); and to compare PBR, PBR-hf and MVHS in persons with T1D and healthy controls.
Methods: Cross-sectional study including 161 persons with T1D stratified by stage of diabetic kidney disease according to level of albuminuria and 50 healthy controls without diabetes. The PBR, PBR-hf and MVHS were assessed by the GlucoCheck device (valid measurements were available in 136 (84.5%) with T1D and in all the controls). Higher PBR and PBR-hf indicate smaller glycocalyx width and lower MVHS represents a worse microvascular health.
Results: There were no associations between PBR, PBR-hf or MVHS and the CV risk factors in persons with T1D, except for a higher PBR-hf and a lower MVHS in females (p = 0.01 for both). There was no difference in PBR, PBR-hf or MVHS in persons with normo-, micro- or macroalbuminuria (p ≥ 0.34). PBR was higher and MVHS was lower in persons with T1D as compared to the healthy controls (p ≤ 0.02). After adjustment for CV risk factors the difference in PBR remained significant (p = 0.001).
Conclusions: The endothelial glycocalyx dimension was impaired in persons with T1D compared to healthy controls. We found no association between the endothelial glycocalyx dimension and the level of albuminuria or CV risk factors among persons with T1D. The use of the GlucoCheck device in T1D may not contribute to CV risk stratification.
E. Buur stougaard: Employee; Spouse/Partner; Novo Nordisk, Stock/Shareholder; Spouse/Partner; Novo Nordisk. S. Winther: None. H. Amadid: Stock/Shareholder; Self; Novo Nordisk A/S. M. Frimodt-moeller: None. F. Persson: Advisory Panel; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Mundipharma International, Novo Nordisk, Advisory Panel; Spouse/Partner; AstraZeneca, Bristol-Myers Squibb Company, Research Support; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Mundipharma International, Novo Nordisk. T. W. Hansen: Stock/Shareholder; Self; Novo Nordisk A/S. P. Rossing: Advisory Panel; Self; Astellas Pharma Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Gilead Sciences, Inc., Merck KGaA, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Vifor Pharma Management Ltd.
Novo Nordisk Foundation (NNF14SA0003)