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Randomized Controlled Trial
. 2020 Dec 23;15(12):e0243737.
doi: 10.1371/journal.pone.0243737. eCollection 2020.

Assessment of the sublingual microcirculation with the GlycoCheck system: Reproducibility and examination conditions

Mie Klessen Eickhoff  1 , Signe Abitz Winther  1 , Tine Willum Hansen  1 , Lars Jorge Diaz  1 , Frederik Persson  1 , Peter Rossing  1   2 , Marie Frimodt-Møller  1
Affiliations
Randomized Controlled Trial

Assessment of the sublingual microcirculation with the GlycoCheck system: Reproducibility and examination conditions

Mie Klessen Eickhoff et al. PLoS One. .

Abstract

Background: The glycocalyx is an extracellular layer lining the lumen of the vascular endothelium, protecting the endothelium from shear stress and atherosclerosis and contributes to coagulation, immune response and microvascular perfusion. The GlycoCheck system estimates glycocalyx' thickness in vessels under the tongue from perfused boundary region (PBR) and microvascular perfusion (red blood cell (RBC) filling) via a camera and dedicated software.

Objectives: Evaluating reproducibility and influence of examination conditions on measurements with the GlycoCheck system.

Methods: Open, randomised, controlled study including 42 healthy smokers investigating day-to-day, side-of-tongue, inter-investigator variance, intraclass-correlation (ICC) and influence of examination conditions at intervals from 0-180 minutes on PBR and RBC filling.

Results: Mean (SD) age was 24.9 (6.1) years, 52% were male. There was no significant intra- or inter-investigator variation for PBR or RBC filling nor for PBR for side-of-tongue. A small day-to-day variance was found for PBR (0.012μm, p = 0.007) and RBC filling (0.003%, p = 0.005) and side-of-tongue, RBC filling (0.025%, p = 0.009). ICC was modest but highly improved by increasing measurements. Small significant influence of cigarette smoking (from 40-180 minutes), high calorie meal intake and coffee consumption was found. The latter two peaking immediately and tapering off but remained significant up to 180 minutes, highest PBR changes for the three being 0.042μm (p<0.05), 0.183μm (p<0.001) and 0.160μm (p<0.05) respectively.

Conclusions: Measurements with the GlycoCheck system have a moderate reproducibility, but highly increases with multiple measurements and a small day-to-day variability. Smoking, meal and coffee intake had effects up to 180 minutes, abstinence is recommended at least 180 minutes before GlycoCheck measurements. Future studies should standardise conditions during measurements.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: MKE has served as educator for Astra Zeneca (all honoraria’s to institution) FP has served as consultant, on advisory boards or as educator for Astra Zeneca, Novo Nordisk, Sanofi, Mundipharma, MSD, Boehringer Ingelheim, Novartis, Amgen and has received research grants to institution from Novo Nordisk, Amgen and Astra Zeneca. PR has served as consultant, on advisory boards or as educator for Astra Zeneca, Astellas, AbbVie, Novo Nordisk, Boehringer Ingelheim, Eli Lilly, Merck, Bayer (all honoraria’s to institution), has shares in Novo Nordisk and has received research grants to institution from Novo Nordisk and Astra Zeneca. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Schematic representation of the lateral movement of erythrocytes and image of measured capillaries.
Fig 2
Fig 2. Study flow chart of the examination of glycocalyx in healthy controls.
See this image and copyright information in PMC

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