Blood rheology and cardiovascular risk factors in type 1 diabetes: relationship with microalbuminuria.
Whole blood and plasma viscosity, erythrocyte aggregation and deformability, plasma fibrinogen, lipids, lipoproteins, apolipoproteins, and measures of blood glucose control were compared between 21 Type 1 diabetic patients with microalbuminuria (overnight albumin excretion rate 30-200 micrograms min-1) and 21 patients with albumin excretion below this range matched for age, sex, and duration of diabetes. Patients with microalbuminuria had significantly higher glycosylated haemoglobin (9.4 +/- 1.6 (+/- SD) vs 7.9 +/- 1.8% (normal range 5.0 to 7.6%)), total-cholesterol (5.6 +/- 1.1 vs 4.6 +/- 1.3 mmol l-1), apolipoprotein B (0.82 +/- 0.21 vs 0.66 +/- 0.14 g l-1), and apolipoprotein B:A1 ratio (0.58 +/- 0.18 vs 0.50 +/- 0.15) than those without microalbuminuria (all p less than 0.05). HDL-cholesterol was also raised (1.71 +/- 0.46 vs 1.43 +/- 0.37 mmol l-1, p less than 0.05). Lipoprotein(a) concentration was possibly higher in the microalbuminuric group (median (95% Cl) 105 (82-140) vs 72 (52-114) mg l-1, p = 0.06). No differences were seen in any of the rheological measurements. These results confirm the presence of potentially atherogenic lipoprotein changes in Type 1 diabetic patients with microalbuminuria, but suggest that altered blood rheology does not predate the development of nephropathy.
Jay
R H
RH
Department of Medicine, University College and Middlesex School of Medicine, UK.
Jones
S L
SL
Hill
C E
CE
Richmond
W
W
Viberti
G C
GC
Rampling
M W
MW
Betteridge
D J
DJ
D000328:Adult; D000419:Albuminuria; D001053:Apolipoproteins / Q000097:blood; D001809:Blood Viscosity; D002318:Cardiovascular Diseases / Q000209:etiology*; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D003930:Diabetic Retinopathy / Q000097:blood / Q000652:urine; D004907:Erythrocyte Deformability; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis; D006400:Hematocrit; D006801:Humans; D017270:Lipoprotein(a); D008074:Lipoproteins / Q000097:blood; D008297:Male; D012212:Rheology; D012307:Risk Factors; D012907:Smoking
D001053:Apolipoproteins; D002784:Cholesterol; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D017270:Lipoprotein(a); D008074:Lipoproteins