Normative data and the influence of age and sex on microcirculatory function in a middle-aged cohort: results from the SCAPIS study

Abstract

The objective of this study was to assess normative values for comprehensive forearm skin microcirculatory function: oxygen saturation, tissue fraction of red blood cells (RBCs), and speed-resolved perfusion. Furthermore, to examine the influence of age and sex on microcirculatory function. Measurements were performed using a noninvasive probe-based system, including diffuse reflectance spectroscopy and laser-Doppler flowmetry, yielding output data in absolute units. The study was conducted within the Swedish CArdioPulmonary BioImage Study (SCAPIS) and included 1,765 men and women aged 50-65 yr from the Linköping general population. Normative values are given at baseline, at the end of a 5-min occlusion of the brachial artery and during hyperemia after occlusion release. We found a consistent age distribution, in which the oldest individuals had the lowest peak oxygen saturation (P < 0.001) and the highest baseline low-speed perfusion (P < 0.001). Women had higher peak oxygen saturation (P < 0.001), lower RBC tissue fraction, in general (P < 0.001), lower baseline perfusion in all speed regions (P = 0.01), and lower peak high-speed perfusion at hyperemia (P < 0.001). The normative data can be used as reference values in future studies of disease-specific populations. The results show that age and sex are important aspects to consider in studies of microvascular function. Women and younger age were factors associated with higher peak oxygen saturation after ischemia. This is a novel parameter that reflects overall microcirculatory function associated with vascular dilation capacity.NEW & NOTEWORTHY This study expands experimental microcirculatory research to clinical use by providing normative values on microcirculatory function in a large population-based cohort. Women and younger age were factors associated with higher peak oxygen saturation after ischemia, which implies that age and sex are important aspects to consider in studies of microvascular function. This study is the first step toward using microcirculatory assessment as a tool to improve diagnosis, prognosis, and treatment in disease-specific populations.

Keywords: ischemia; microvascular blood flow; oxygen saturation.

Conflict of interest statement

I. Fredriksson is part-time employed by Perimed, AB, which is developing products related to research described in this publication. None of the other authors have disclosable conflicts of interests.

Figures

Fig. 1.

An individual recording of the microcirculatory parameters. A: oxygen saturation and red blood cell (RBC) tissue fraction. B: total perfusion and speed resolved perfusion for speeds <1, 1–10, and >10 mm/s. The marked time intervals in gray represent calculated baseline and occlusion values, and peak values after release are marked with asterisks.

Fig. 2.

Histogram of oxygen saturation (A), red blood cell (RBC) tissue fraction (B) and speed-resolved perfusion, below 1 mm/s (C), 1–10 mm/s (D), above 10 mm/s (E), and total perfusion (F). Note that the widths of the bars differ to improve visibility.

Fig. 3.

Mean percentage of total perfusion for the three perfusion components during baseline, occlusion, and peak.

Fig. 4.

Average time traces of oxygen saturation and red blood cell (RBC) tissue fraction (A) and speed-resolved perfusion (B) for two age groups.

Fig. 5.

Average time traces of oxygen saturation and red blood cell (RBC) tissue fraction (A) and speed-resolved perfusion (B) for men and women.