糖尿病および前糖尿病者における皮膚細小血管障害の臨床的研究
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概要
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In order to study the characteristic findings of diabetic micro angiopathy, clinicopathological investigation was performed based on skin biopsies. The patients consist of 79 diabetics, 9 prediabetics suspected and 32 non-diabetic controls. The skin biopsy specimens obtained by punch method were subjected to observing and grading the thickening of arteriolar basement membrane by lightmicroscope. And then, these histological findings were assessed in correlation to their clinical manifestations. The results were as follows. 1) Characteristic vascular alteration of the skin in diabetics : Moderate to severe arteriolar wall thickening presented in 41.7% of diabetics and 3.1% of the control, and these changes were considered to be characteristic in diabetics. On the contrary, mild change was found in 34.2% of diabetic group and 40.6% of nondiabetic group, and this change was not charactesistic finding in diabetics. 2) Glinicopathological findings in diabetics : Increasing severity of skin vascular alterations was closely correlated with increasing duration of diabetes and presence of diabetic retinopathy. Slightly positive correlation presented between the severity of skin changes and presence of diabetic nephropathy. However, mild skin change was also developed by non-specific factors, i. e. chronological age and arteriolosclerosis. 3) Skin vascular alteration in prediabetics suspected : Moderate arteriolar thickening was recognized in 2 cases, mild in 6 and normal in only one. Compared these findings with those in the control of the same age group, it was proved that the pathological skin change was found in even prediabetics suspected. From these observations, it was concluded that the skin arteriolar lesion might develop as a part of generalized diabetic microangiopathy.
- 千葉大学の論文