Endoneurial Capillary Abnormalities Presage Deterioration of Glucose Tolerance and Accompany Peripheral Neuropathy in Man
- Soley Thrainsdottir1,
- Rayez A. Malik2,
- Lars B. Dahlin3,
- Peter Wiksell4,
- Karl F. Eriksson5,
- Ingmar Rosén6,
- Jesper Petersson1,
- Douglas A. Greene7 and
- Göran Sundkvist4
- 1Department of Neurology, University of Lund, Malmö University Hospital, Malmö, Sweden
- 2Academic Department of Medicine, Royal Infirmary, Manchester, U.K
- 3Department of Hand Surgery, University of Lund, Malmö University Hospital, Malmö, Sweden
- 4Department of Endocrinology, University of Lund, Malmö University Hospital, Malmö, Sweden
- 5Department of Vascular Diseases, University of Lund, Malmö University Hospital, Malmö, Sweden
- 6Department of Clinical Neurophysiology, University of Lund, Malmö University Hospital, Malmö, Sweden
- 7Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
- Address correspondence and reprint requests to Professor Göran Sundkvist, MD, Department of Endocrinology, Malmö University Hospital, SE 205 02 Malmö, Sweden. E-mail: goran.sundkvist{at}endo.mas.lu.se
Abstract
To explore whether microangiopathy is associated with disturbed glucose tolerance and peripheral neuropathy, we assessed endoneurial capillary morphology in sural nerve biopsies from men with diabetes, impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). Baseline morphology was related to glucose tolerance and neuropathy at baseline and at follow-up 6 years later. Capillary density (in number per millimeters squared) at baseline was higher in subjects with diabetes (n = 10) compared with those with NGT (n = 5) at follow-up (median [interquartile range]) (86.0 [24.3] vs. 54.9 [17.1]; P = 0.0200) and in those progressing from IGT to diabetes (n = 4) compared with those with persistent IGT (n = 4) (86.7 [25.2] vs. 54.1 [14.6]; P = 0.0433). The capillary luminal area (in micrometers squared) was lower in subjects with NGT progressing to IGT (n = 2) or subjects with IGT progressing to diabetes (n = 3) compared with subjects with constant NGT (n = 6) or constant IGT (n = 4) (11.9 [2.4] vs. 20.8 [7.8]; P = 0.0201). The capillary basement membrane area (in micrometers squared) was increased in patients with peripheral neuropathy (n = 10) compared with those without (n = 7) (114.6 [68.8] vs. 75.3 [28.7]; P = 0.0084). In conclusion, increased capillary density was associated with current or future diabetes, decreased capillary luminal area with future deterioration in glucose tolerance, and increased basement membrane area with peripheral neuropathy.
- IGT, impaired glucose tolerance
- MNFD, myelinated nerve fiber density
- NDS, Neuropathy Disability Score
- NGT, normal glucose tolerance
- OGTT, oral glucose tolerance test
- SNAP, sural nerve action potential
- SNCV, sural nerve conduction velocity
Footnotes
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- Accepted July 17, 2003.
- Received April 7, 2003.
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