CUTANEOUS MEASURES OF DIABETIC NEUROPATHY

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。这项建议的目的是开发、评估和验证适用于早期糖尿病典型的疼痛、小纤维神经病变的神经病变进展的替代措施，并调查皮肤微血管功能障碍与其他微血管终点(视网膜病变和肾病)之间的关系。我们假设一氧化氮减少和微血管损伤在糖尿病神经病变的发生中起重要作用，皮肤微血管功能异常将先于神经病变和其他微血管并发症的发展。皮肤活检和测量表皮内神经纤维密度(IENFD)将是随后轴突丢失的敏感标志，并将作为早期糖尿病肾病进展的有用测量。该项目的目标是验证IENFD作为轻度糖尿病肾病的进展指标，并将皮肤微血管功能障碍与小纤维丢失的严重程度和发生微血管并发症的风险联系起来。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this proposal is to develop, evaluate, and validate surrogate measures of neuropathy progression appropriate to the painful, small fiber neuropathy typical of early diabetes and to investigate the relationship between cutaneous microvascular dysfunction and other microvascular endpoints (retinopathy and nephropathy). We hypothesize that decreased nitric oxide and microvascular injury are important in the initiation of diabetic neuropathy (DN), and abnormal cutaneous microvascular function will precede the development of neuropathy and other microvascular complications. Skin biopsy with measurement of intraepidermal nerve fiber density (IENFD) will be a sensitive marker of subsequent axonal loss and will serve as a useful measure of early DN progression. The project goals are to validate IENFD as a progression measure of mild DN and to correlate cutaneous microvascular dysfunction with severity of small fiber loss and risk of developing microvascular complications.