Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.202301062
Jornal Vascular Brasileiro
Original Article

Peripheral tissue perfusion in individuals with and without type 2 diabetes mellitus and its associations with type 2 diabetes: a cross-sectional study

Perfusão tecidual periférica em indivíduos com e sem diabetes mellitus tipo 2 e suas associações com diabetes tipo 2: estudo transversal

Valéria Cristina de Faria; Juliana Simões de Alencar Fernandes; Tulio Ericles de Oliveira Cunha; Guilherme de Azambuja Pussieldi; Danielle Aparecida Gomes Pereira

http://dx.doi.org/10.1590/1677-5449.202301062 J Vasc Bras, vol.24, e20230106, 2024
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Abstract

Background: Early recognition of peripheral tissue perfusion deficits can minimize secondary complications of peripheral arterial disease in individuals with diabetes.

Objectives: To compare parameters of peripheral tissue perfusion in the leg at rest and during and after progressive effort between non-diabetics and individuals with type 2 diabetes and normal ankle brachial index values, as well as to evaluate the factors associated with peripheral tissue perfusion in the leg in individuals with type 2 diabetes during progressive effort.

Methods: This cross-sectional study included 31 individuals with type 2 diabetes and 31 non-diabetics. Anthropometric measurements and physical activity levels were assessed in all individuals. Peripheral tissue perfusion was analyzed using near-infrared spectroscopy during an arterial occlusion maneuver and the Incremental Shuttle Walking Test.

Results: During progressive effort, the tissue oxygen saturation level was lower in the type 2 diabetes group (type 2 diabetes, 58.74 [56.27–61.74] than the non-diabetic group, 62.15 [59.09–66.49]; p = 0.005). There were significant correlations between tissue oxygen saturation during progressive effort and physical activity level (p < 0.0001; r = -0.681), total body fat percentage (p = 0.001; r = 0.590), segmental body fat percentage (p < 0.0001; r = 0.616), total skeletal muscle mass (p < 0.0001; r = -0.628), and segmental skeletal muscle mass (p = 0.001; r = -0.592).

Conclusions: Individuals with type 2 diabetes and normal ankle-brachial index values had worse tissue perfusion during progressive effort than non-diabetics, and there was an association between perfusion, physical activity level, and body composition in the type 2 diabetes group.

Keywords

leg; microcirculation; near-infrared spectroscopy; type 2 diabetes mellitus

Resumo

Contexto: O reconhecimento precoce dos déficits de perfusão tecidual periférica pode minimizar as complicações secundárias da doença arterial periférica em indivíduos com diabetes.

Objetivos: Comparar parâmetros de perfusão tecidual periférica do membro inferior em repouso e durante e após esforço progressivo entre indivíduos com diabetes tipo 2 (DM2) com índice tornozelo-braquial (ITB) normal e indivíduos sem diabetes. Além disso, avaliar os fatores associados à perfusão tecidual periférica do membro inferior em indivíduos com DM2 durante esforço progressivo.

Métodos: Estudo transversal que avaliou 62 indivíduos: 31 com DM2 e 31 sem diagnóstico de diabetes (SDD). Em ambos os grupos, foram avaliadas medidas antropométricas e níveis de atividade física. A perfusão tecidual periférica foi analisada por espectroscopia de infravermelho próximo durante a manobra de oclusão arterial e o Incremental Shuttle Walking Test.

Resultados: O nível de saturação tecidual de oxigênio (StO2) durante o esforço progressivo foi menor no grupo DM2 (DM2: 58,74 [56,27–61,74]; SDD: 62,15 [59,09–66,49]; p = 0,005). Houve correlações significativas entre o nível de StO2 durante o esforço progressivo e nível de atividade física (p < 0,0001; r = -0,681), percentual de gordura corporal total (p = 0,001; r = 0,590), percentual de gordura corporal segmentar (p < 0,0001; r = 0,616), massa muscular esquelética total (MME) (p < 0,0001; r = -0,628) e MME segmentar (p = 0,001; r = -0,592).

Conclusões: Indivíduos com DM2 com ITB normal apresentaram pior perfusão tecidual durante o esforço progressivo em comparação aos indivíduos com SDD. Essa pior perfusão foi associada ao nível de atividade física e à composição corporal nos indivíduos com DM2.

Palavras-chave

membro inferior; microcirculação; espectroscopia de luz próxima ao infravermelho; diabetes mellitus tipo 2

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Submitted date:
09/10/2023

Accepted date:
12/09/2024

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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