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Capillary permeability is increased in normo‐ and microalbuminuric Type 1 diabetic patients: amelioration by ACE‐inhibition
Author(s) -
Oomen,
Jäger,
Hoogenberg,
Dullaart,
Reitsma,
Smit
Publication year - 1999
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1999.00568.x
Subject(s) - microalbuminuria , medicine , enalapril , diabetes mellitus , vascular permeability , ace inhibitor , blood pressure , endocrinology , type 2 diabetes , angiotensin converting enzyme
Background Capillary leakage of sodium‐fluorescein (NaF) in the skin reflects capillary permeability and may be a marker of diabetes‐associated microcirculatory abnormalities. Design We evaluated transcapillary skin NaF leakage by fluorescence videodensitometry in 10 normoalbuminuric, 10 microalbuminuric Type 1 diabetic men (diabetes duration > 10 years) and 10 healthy subjects. The microalbuminuric patients were restudied after 6 weeks treatment with the ACE‐inhibitor enalapril, 10 mg once daily. All measurements were performed at a blood glucose level of 5 mmol L −1 . Results Transcapillary NaF leakage was strongly increased in normoalbuminuric Type 1 diabetic patients compared to healthy subjects ( P < 0.001) and was still further increased in microalbuminuric Type 1 diabetic patients ( P < 0.01 compared to normoalbuminuric patients). Enalapril reduced NaF leakage ( P < 0.05), mean arterial blood pressure ( P < 0.05) and microalbuminuria ( P < 0.05). After treatment, NaF leakage was not different from that in normoalbuminuric patients. Conclusions Capillary permeability, as determined by NaF leakage, is elevated in normoalbuminuric Type 1 diabetic patients with long‐standing disease, and the excess elevation in microalbuminuric Type 1 diabetic patients is ameliorated by ACE‐inhibition. Skin NaF videodensitometry seems a useful tool to document capillary permeability in intervention studies.