Affiliations: [a] School of Medicine, University of Nottingham, Nottingham, UK | [b] Centre for Sports and Exercise Science, Sheffield Hallam University, Sheffield, UK | [c] Derby Hospitals NHS Foundation Trust, Derby, UK | [d] University Hospitals of Leicester, Leicester, UK
Correspondence:
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Corresponding author: Richard Donnelly, School of Medicine, Division of Medical Sciences & Graduate, Entry Medicine University of Nottingham, Royal Derby Hospital Centre, Uttoxeter Road, Derby DE22 3DT, UK. Tel.: +44 1332 724682; Fax: +44 1332 724169; E-mail: [email protected].
Abstract: AIMS:To evaluate endothelial-dependent and – independent cutaneous vasodilator responses in the feet of patients with peripheral arterial disease (PAD) with or without Type 2 diabetes. METHODS:Cutaneous microvascular responses in the dorsum of both lower limbs were measured in the supine position using Laser Doppler Fluximetry combined with iontophoretic administration of endothelial-dependent (acetylcholine, Ach) and -independent (sodium nitroprusside, SNP) vasodilators in diabetic (n = 19) and non diabetic (n = 17) patients with PAD (presenting as unilateral calf intermittent claudication (IC). RESULTS:In patients with diabetes and IC, endothelial-dependent vasodilation was significantly impaired in the symptomatic limb [74 (57,105) vs 68 (24,81) PU, Z =−2.79, p = 0.005] compared to the asymptomatic limb. Patients without diabetes showed no impairment of vasodilation. Resting ankle-brachial pressure index did not identify the presence of abnormalities in microvascular function. CONCLUSIONS:The combination of diabetes and PAD is associated with a reduction in endothelial-dependent cutaneous vasodilation in the feet without an associated reduction in endothelial independent vasodilation.
