Association Between Maximum Lifetime Body Mass Index and Nailfold Capillary Changes in Patients With Type 2 Diabetes Mellitus

Maiko Shikama; Sayaka Suga; Tetsuya Tajima; Junji Kozawa; Norikazu Maeda; Michio Otsuki; Taka-Aki Matsuoka; Iichiro Shimomura; Yuko Ohno

doi:10.7759/cureus.75411

Association Between Maximum Lifetime Body Mass Index and Nailfold Capillary Changes in Patients With Type 2 Diabetes Mellitus

Cureus. 2024 Dec 9;16(12):e75411. doi: 10.7759/cureus.75411. eCollection 2024 Dec.

Authors

Maiko Shikama¹, Sayaka Suga², Tetsuya Tajima³, Junji Kozawa⁴, Norikazu Maeda⁵, Michio Otsuki⁶, Taka-Aki Matsuoka⁷, Iichiro Shimomura⁴, Yuko Ohno³

Affiliations

¹ Department of Fundamental Nursing, Shiga University of Medical Science, Shiga, JPN.
² Department of Nursing, Graduate School of Health Sciences, Kobe University, Kobe, JPN.
³ Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka, JPN.
⁴ Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, JPN.
⁵ Department of Endocrinology, Metabolism, and Diabetes, Faculty of Medicine, Kindai University, Osaka, JPN.
⁶ Department of Endocrinology, Tokyo Women's Medical University, Tokyo, JPN.
⁷ First Department of Medicine, Wakayama Medical University, Wakayama, JPN.

Abstract

Objective: Microvascular changes, such as crossing nailfold capillaries, could be crucial for linking maximum lifetime body mass index (BMI) and microvascular complications in patients with type 2 diabetes mellitus (T2DM). However, the relationship between maximum lifetime BMI and microvascular changes remains elusive. This study aimed to elucidate the relationship between maximum lifetime BMI and the percentage of crossing nailfold capillaries among patients with T2DM.

Methodology: As an extension of a cross-sectional study at Osaka University Hospital, this study was conducted among 63 patients with T2DM aged 40-75 years. Maximum lifetime BMI data were extracted from medical records, and nailfold capillaroscopy was applied to assess capillary morphology, following the simple capillaroscopic definitions established by the European Alliance of Associations for Rheumatology Study Group. The association between maximum lifetime BMI and percentage of crossing fingernailfold capillaries was evaluated using multiple linear regression, adjusting for potential confounders such as age, sex, obesity status at the time of the survey, and other diabetes-related factors.

Results: After adjusting for confounding factors, maximum lifetime BMI was significantly correlated with higher crossing capillary percentage (standardized regression coefficients: 0.47; P = 0.026). BMI at the time of the survey showed no significant association with the percentage of crossing capillaries (standardized regression coefficients: -0.21; P = 0.381).

Conclusions: Maximum lifetime BMI was associated with a higher percentage of crossing capillaries in patients with T2DM, rather than obesity status at the time of the survey. These results emphasize the importance of lifelong weight management in the prevention of T2DM and its complications and highlight the necessity of considering maximum lifetime BMI alongside current BMI in the management of patients with T2DM.

Keywords: microvascular dysfunction; nail fold capillaroscopy; nail fold capillary; obesity history; past obesity.

Grants and funding

This study was supported by grants from JSPS KAKENHI (Grant Number 22K17438), the Japan Health Foundation, and the Yamaji Fumiko Nursing Research Fund.