Summary
Ultrastractural morphometry was used to quantify capillary basement membrane width, pericyte coverage of capillaries, pericyte degeneration, and the extent of acellular capillaries in skeletal muscle obtained at autopsy from neck, thigh, calf and foot of five male and four female diabetic subjects and an equal number of sex- and age-matched nondiabetic subjects. Within diabetic or nondiabetic subjects, the trend for all four parameters to increase in frequency or magnitude in the order neck < thigh < calf was highly significant; the only statistically significant difference between calf and foot muscles for any of the four parameters was capillary basement membrane width for nondiabetic subjects, which was significantly thinner in foot than in calf muscle (t=2.45;p<0.05). Pericyte coverage of capillaries did not differ between diabetic and nondiabetic subjects for each muscle examined; however, capillary basement membrane width, the frequency of pericyte debris and acellular capillaries were increased significantly in the lower extremity muscles of diabetic compared to nondiabetic subjects, and the magnitude of the difference between these two groups increased in the order thigh < calf < foot. The observations that pericyte degeneration and acellular capillaries are present in skeletal muscle as well as in retinal microvessels suggest that common pathophysiological mechanisms may contribute to vascular disease in these two very different tissues. The additional finding that relative differences between diabetic and nondiabetic subjects, in the frequency and magnitude of these changes, increase in the order neck < calf < foot is consistent with the marked increase in peripheral vascular disease and gangrene in the lower extremities of diabetic patients.
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Cogan DG, Toussaint D, Kuwabara T (1961) Retinal vascular patterns. IV. Diabetic retinopathy. Arch Ophthalmol 66: 366–378
Cogan DG, Kuwabara T (1963) Capillary shunts in the pathogenesis of diabetic retinopathy. Diabetes: 12: 293–300
Garner A (1970) Pathology of diabetic retinopathy. Br Med Bull 26: 137–142
Yanoff M (1969) Ocular pathology of diabetes mellitus. Am J Ophthalmol 67: 21–38
Tilton RG, Hoffmann PL, Kilo C, Williamson JR (1981) Pericyte degeneration and basement membrane thickening in skeletal muscle capillaries of human diabetics. Diabetes 30: 326–334
Bell ET (1957) Atherosclerotic gangrene of the lower extremities in diabetic and nondiabetic persons. Am J Clin Pathol 28: 27–36
Williamson JR, Vogler NJ, Kilo C (1969) Estimation of vascular basement membrane thickness: theoretical and practical considerations. Diabetes 18: 567–578
Vracko R (1970) Skeletal muscle capillaries in diabetics. A quantitative analysis. Circulation 41: 271–283
Friederici AHR, Tucker WR, Schwartz TB (1966) Observations on small blood vessels of skin in the normal and in diabetic patients. Diabetes 15: 233–250
Yodaiken RE, Seftel HC, Rubenstein AN (1967) Ultrastructure of dermal capillaries of Africans in South Africa. Diabetes 16: 191–197
Ashton N (1953) Central areolar choroidal sclerosis. A histopathological study. Br J Ophthalmol 37: 140–147
Kohner EM, Dollery CT, Paterson JW, Oakley NW (1967) Arterial fluorescein studies in diabetic retinopathy. Diabetes 16: 1–10
Ashton N (1959) Diabetic retinopathy. A new approach. Lancet 2: 625–630
Ashton N (1953) Arteriolar involvement in diabetic retinopathy. Br J Ophthalmol 37: 282–292
Ashton N (1961) Neovascularization in ocular tissue. Trans Ophthalmol Soc UK 81: 145–161
Bresnick GH, de Venecia G, Myers FL, Harris JA, Davis MD (1975) Retinal ischemia in diabetic retinopathy. Arch Ophthalmol 93: 1300–1310
Scott DJ, Dollery CT, Hill DW, Hodge JV, Fraser R (1964) Fluorescein studies of diabetic retinopathy. Br Med J 1: 811–814
Oosterhuis JA, Vink R (1968) Fluorescein photography in diabetic retinopathy. In: Henkes H (ed) Perspectives in Ophthalmology. Excerpta Medical Foundation, Rotterdam, pp 115–132
Kohner EM, Henkind P (1970) Correlation of fluorescein angiogram and retinal digest in diabetic retinopathy. Am J Ophthalmol 69: 403–414
Zacks SI, Pegues JJ, Elliott FA (1962) Interstitial muscle capillaries in patients with diabetes mellitus: a light and electron microscopic study. Metabolism 11: 381–393
Williamson JR, Kilo C, Crespin SR (1977) Vascular disease. In: Levin ME, O'Neal LW (eds) The Diabetic Foot. C.V.Mosby, St. Louis, pp 67–96
Kumar S, West D, Shahabuddin S, Arnold F, Haboubi N, Reid H, Carr T (1983) Angiogenesis factor from human myocardial infarcts. Lancet 2: 364–367
Akagi Y, Kador PF, Kuwabara T, Kinoshita JH (1983) Aldose reductase localization in human retinal mural cells. Invest Ophthalmol Vis Sci 24: 1516–1519
Buzney SM, Frank RN, Varma SD, Tanishima T, Gabbay KH (1977) Aldose reductase in retinal mural cells. Invest Ophthalmol Vis Sci 16: 392–396
Tilton RG, Kilo C, Williamson JR, Murch DW (1979) Differences in pericyte contractile function in rat cardiac and skeletal muscle. Microvasc Res 18: 336–352
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Tilton, R.G., Faller, A.M., Burkhardt, J.K. et al. Pericyte degeneration and acellular capillaries are increased in the feet of human diabetic patients. Diabetologia 28, 895–900 (1985). https://doi.org/10.1007/BF00703132
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DOI: https://doi.org/10.1007/BF00703132