John Cederqvist

Micro – and Macrovascular function in various stages of dysglycemia.

Diabetes Mellitus is a risk factor for developing micro-and macrovascular complications. Exploring macro- and microcirculatory function in various stages of dysglycemia can potentially be a new way of detecting early signs of vascular disease.

Diabetes Mellitus (DM) is a risk factor for developing micro-and macrovascular complications.
There are several risk stratification models available to estimate the risk of cardiovascular disease. The ankle brachial indexes (ABI) estimates the peripheral, macrovascular circulation and the SCORE (Systematic COronary Risk Evaluation) model estimates the 10-year risk of a cardiovascular event by appreciate known risk factors. However, this risk model is not applicable for patients with diabetes.

The use of pulse wave velocity (PWV) to estimate macrovascular function and bio-optics for microvascular function is a potential new way to find a more accurate way to analyze blood vessel circulation in various stages of dysglycemia.

The general aim of this thesis will be to use objective technologies to characterize the function of the micro- and macrovascular bed to improve risk prediction for cardiovascular disease (CVD) in a general population of participants aged 50-64 years with emphasis on different stages of glycaemic control

Data from the Swedish CArdiopulumonary bioImage Study (SCAPIS), a Swedish, unique multi-center study with a total of 30 000 participants from 6 Swedish cities. The cohort was randomly selected men and women in the age range of 50 to 64 years. PWV was measured in a sub-sample of 9413 participants in total from Linköping and Malmö. Microvascular function was measured in 3300 participants from Linkoping. In this project, dysglycemia (IFG and DM) and normal controls is categorized according to European standard.

PWV
PWV is calculated as the distance (m) between two sites (carotid artery versus the femoral artery) divided by time (s) for the pulse wave to travel. Increased velocity indicates stiffer blood vessels.

Microcirculatory function
Will be measured by use of PeriFlux 6000 EPOS (enhanced perfusion and oxygen saturation monitoring), a system that utilize a bio-optical way for measuring oxygenation saturation, speed resolved perfusion and local red blood cell tissue fraction in the skin of the forearm. This thesis will contribute to increase the understanding of the mechanisms that drive the development of the micro- and macrovascular dysfunction in different stage of dysglycemia.

This thesis will contribute to increase the understanding of the mechanisms that drive the development of the micro- and macrovascular dysfunction in different stage of dysglycemia.


Linköpings University

Supervisor: Carl Johan Östgren, MD, PhD
Professor