The Relationship Between Sublingual Microcirculatory Structure and Frailty in Renal Transplant Candidates: Exploring Tortuosity & Endothelial Glycocalyx Biomarkers

IF 2.4 4区医学 Q3 HEMATOLOGY

Microcirculation Pub Date : 2026-06-04 DOI:10.1111/micc.70072

Ryan A. P. Homes, Trent Payne, Fiona Giddens, Ross S. Francis, Ruth E. Hubbard, Emily H. Gordon, Mark J. Midwinter

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引用次数: 0

Abstract

Objective

This study investigated the relationship between sublingual microcirculatory tortuosity, frailty index scores, and endothelial glycocalyx blood biomarkers in individuals with chronic kidney disease (CKD).

Methods

Sublingual microcirculatory videos were analyzed using a 0–4 tortuosity scoring scale. Plasma concentrations of syndecan-1 and soluble thrombomodulin were quantified using enzyme-linked immunosorbent assay (ELISA). Frailty status was assessed using a short-form frailty index questionnaire.

Results

The study included 44 patients (median age 53 years, IQR 45–64) attending a kidney transplant assessment clinic, with equal representation of males and females. The median frailty index was 0.19 (IQR: 0.15–0.30), with 63.5% of participants having an FI score < 0.25. Intraclass correlation coefficient (ICC) analysis demonstrated excellent inter-observer reliability for tortuosity scoring. Frailty index scores were significantly higher in participants with tortuosity scores of 3/4 compared to those with a score of 0. No significant differences were observed in syndecan-1 or soluble thrombomodulin levels across tortuosity scores. Ordinal logistic regression identified frailty index score as the only significant predictor of tortuosity, independent of age, dialysis type, or sex.

Conclusions

Higher frailty index scores were associated with increased sublingual microcirculatory capillary tortuosity, though this relationship did not extend to endothelial glycocalyx biomarkers. These findings highlight the potential value of incorporating tortuosity assessment alongside density and perfusion measures in microcirculatory evaluation.

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舌下微循环结构与肾移植候选人脆弱性的关系：探索扭曲和内皮糖萼生物标志物。

目的：本研究探讨慢性肾脏疾病（CKD）患者舌下微循环扭曲、衰弱指数评分和内皮糖萼血液生物标志物之间的关系。方法：采用0-4度曲度评分法对舌下微循环录像进行分析。采用酶联免疫吸附法（ELISA）测定血浆syndecan-1和可溶性血栓调节素浓度。采用短格式的衰弱指数问卷对衰弱状态进行评估。结果：本研究纳入44例患者（中位年龄53岁，IQR 45-64），在肾移植评估诊所就诊，男女比例相等。中位脆弱指数为0.19 (IQR: 0.15-0.30)， 63.5%的参与者有FI评分。结论：较高的脆弱指数评分与舌下微循环毛细血管扭曲增加相关，但这种关系并不延伸到内皮糖盏生物标志物。这些发现强调了在微循环评估中结合扭曲度评估以及密度和灌注测量的潜在价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.