Akademik Veri Yönetim Sistemi
62nd Annual ESPE (ESPE 2024), Liverpool, İngiltere, 16 - 18 Ekim 2024, ss.33-34, (Özet Bildiri)
Background: Nail-fold capillaroscopy (NFC), a non-invasive
tool that can detect microvascular changes, has recently gained
popularity in the diabetes field as a warning sign before the development
of diabetes-related complications.
Objective: We aimed to assess capillary microarchitecture in
children with type 1 diabetes mellitus (T1DM) by comparing them
with a healthy control group.
Subjects and Methods: The study included 55 children aged
between 6-18 years with T1DM for at least a year and 55 age-matched
healthy controls without diabetes. We collected data on diabetes
duration, average HbA1c values over the past year for all patients,
and data from the preceding 3 months for patients using 24-hour
continuous glucose monitoring (CGM) devices. The capillaroscopic
findings were evaluated by two different researchers with experience
in the field of pediatric rheumatology. Capillaroscopic parameters
were compared in patients with diabetes based on glycemic control
(HbA1c ≥7.5%, poor control; <7.5%, good control) and disease
duration (<5 years vs. ≥5 years). For patients who used CGM [n= 22,
median duration of diabetes 3.1 (1.7–5.7) years], the capillaroscopic
findings were also compared based on their time in range (≥70% vs.
<70%) and glucose variability (≤36% vs. >36%).
Results: The median age of patients with T1DM was 14.5
(11.3–17.2) years, with a median disease duration of 3.8 (2.3–6.7)
years. Patients with diabetes showed a significantly lower capillary
density and a higher prevalence of dilated, tortuous, cross-linked,
and abnormal morphological capillaries than healthy individuals
(p<0.001). Patients with poor glycemic control exhibited significantly
lower capillary density than those with good glycemic control
(p<0.001). After adjusting for age, gender, BMI, and diabetes
duration, a negative correlation between capillary density and
average HbA1c was observed (r= -0.4, p=0.004). Among patients
with T1DM, those with a disease duration of ≥5 years hadsignificantly reduced capillary density compared to those with a
duration of <5 years (p=0.02). Additionally, capillary density negatively
correlated with disease duration (r= -0.3, p=0.02).
Capillaroscopic findings were similar based on the time in range
and glucose variability of patients using CGM.
Conclusion: Patients with T1DM exhibited significantly higher
microvascular changes, mostly associated with poor glycemic control,
compared to healthy controls. NFC can be a useful technique
for detecting early alterations in the capillary structures of children
with T1DM, even in the absence of microvascular complications.