CUTANEOUS MEASURES OF DIABETIC NEUROPATHY

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 本提案的目的是开发、评价和验证适用于早期糖尿病典型疼痛性小纤维神经病变的神经病变进展替代指标，并研究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。 我们推测，减少一氧化氮和微血管损伤是重要的糖尿病神经病变（DN）的开始，和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。 皮肤活检和表皮内神经纤维密度（IENFD）的测量将是一个敏感的标记，随后轴突损失，并将作为一个有用的措施，早期DN进展。 该项目的目标是验证IENFD作为轻度DN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相关联。

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.