Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes
Background Type 2 diabetes mellitus (DM) leads to chronic hyperglycemia and microvascular complications, including diabetic nephropathy (DN). Nailfold videocapillaroscopy (NVC) is a non-invasive method for assessing the microvascular abnormalities and may aid in early DN detection. This study invest...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2458766 |
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| author | Po-Chi Hsu Pei-Yung Liao Ssu-Wei Huang Hen-Hong Chang John Y. Chiang Lun-Chien Lo |
| author_facet | Po-Chi Hsu Pei-Yung Liao Ssu-Wei Huang Hen-Hong Chang John Y. Chiang Lun-Chien Lo |
| author_sort | Po-Chi Hsu |
| collection | DOAJ |
| description | Background Type 2 diabetes mellitus (DM) leads to chronic hyperglycemia and microvascular complications, including diabetic nephropathy (DN). Nailfold videocapillaroscopy (NVC) is a non-invasive method for assessing the microvascular abnormalities and may aid in early DN detection. This study investigates the correlation between DN and nailfold capillary abnormalities in type 2 DM.Methods This prospective cross-sectional study involved 453 participants with type 2 DM, divided into 3 groups based on estimated glomerular filtration rate (eGFR) or albumin-to-creatinine (A/C) ratio. Chronic kidney disease (CKD) risk categories based on the 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Participants underwent structured interviews, clinical assessments, and laboratory tests. NVC was performed to assess capillary morphology, distribution, density, and blood flow.Results Significant differences in NVC measurements were observed across eGFR groups, with higher NVC scores and more severe capillary abnormalities noted in lower eGFR groups. The ‘comma-like’ capillary distribution pattern (23.08%, p = 0.016), more ratio of ramified capillaries (p = 0.0137) were observed in the eGFR <30 ml/min/1.73m2 group. Reduced fundus transparency (p = 0.0015) and impaired visibility of the sub-venous plexus (p = 0.0016) were noted in the lower eGFR groups. Capillary lengths, both input and mean, were shorter in the A/C ratio > 300 mg/g group (p = 0.0382 and p = 0.0478, respectively). The NVC score was higher in the A/C ratio > 300 mg/g groups (p = 0.0028).Conclusion Nailfold capillary abnormalities correlate with DN severity, indicating their potential as a non-invasive biomarker for early DN detection and monitoring in type 2 DM. |
| format | Article |
| id | doaj-art-4e1fbd458dd54afdb2d23b19e7f9006f |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-4e1fbd458dd54afdb2d23b19e7f9006f2025-02-03T13:18:58ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2458766Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetesPo-Chi Hsu0Pei-Yung Liao1Ssu-Wei Huang2Hen-Hong Chang3John Y. Chiang4Lun-Chien Lo5School of Chinese Medicine, China Medical University, Taichung, TaiwanGraduate Institute of Chinese Medicine, China Medical University, Taichung, TaiwanDepartment of Chinese Medicine, China Medical University Hospital, Taichung, TaiwanDepartment of Chinese Medicine, China Medical University Hospital, Taichung, TaiwanDepartment of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, TaiwanSchool of Chinese Medicine, China Medical University, Taichung, TaiwanBackground Type 2 diabetes mellitus (DM) leads to chronic hyperglycemia and microvascular complications, including diabetic nephropathy (DN). Nailfold videocapillaroscopy (NVC) is a non-invasive method for assessing the microvascular abnormalities and may aid in early DN detection. This study investigates the correlation between DN and nailfold capillary abnormalities in type 2 DM.Methods This prospective cross-sectional study involved 453 participants with type 2 DM, divided into 3 groups based on estimated glomerular filtration rate (eGFR) or albumin-to-creatinine (A/C) ratio. Chronic kidney disease (CKD) risk categories based on the 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Participants underwent structured interviews, clinical assessments, and laboratory tests. NVC was performed to assess capillary morphology, distribution, density, and blood flow.Results Significant differences in NVC measurements were observed across eGFR groups, with higher NVC scores and more severe capillary abnormalities noted in lower eGFR groups. The ‘comma-like’ capillary distribution pattern (23.08%, p = 0.016), more ratio of ramified capillaries (p = 0.0137) were observed in the eGFR <30 ml/min/1.73m2 group. Reduced fundus transparency (p = 0.0015) and impaired visibility of the sub-venous plexus (p = 0.0016) were noted in the lower eGFR groups. Capillary lengths, both input and mean, were shorter in the A/C ratio > 300 mg/g group (p = 0.0382 and p = 0.0478, respectively). The NVC score was higher in the A/C ratio > 300 mg/g groups (p = 0.0028).Conclusion Nailfold capillary abnormalities correlate with DN severity, indicating their potential as a non-invasive biomarker for early DN detection and monitoring in type 2 DM.https://www.tandfonline.com/doi/10.1080/07853890.2025.2458766Diabetic nephropathynailfold videocapillaroscopyestimated glomerular filtration rate2012 kidney disease Improving Global Outcomescross-sectional study |
| spellingShingle | Po-Chi Hsu Pei-Yung Liao Ssu-Wei Huang Hen-Hong Chang John Y. Chiang Lun-Chien Lo Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes Annals of Medicine Diabetic nephropathy nailfold videocapillaroscopy estimated glomerular filtration rate 2012 kidney disease Improving Global Outcomes cross-sectional study |
| title | Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes |
| title_full | Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes |
| title_fullStr | Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes |
| title_full_unstemmed | Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes |
| title_short | Nailfold capillary abnormalities as indicators of diabetic nephropathy progression: a cross-sectional study in type 2 diabetes |
| title_sort | nailfold capillary abnormalities as indicators of diabetic nephropathy progression a cross sectional study in type 2 diabetes |
| topic | Diabetic nephropathy nailfold videocapillaroscopy estimated glomerular filtration rate 2012 kidney disease Improving Global Outcomes cross-sectional study |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2458766 |
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