Rheological determinants of red blood cell aggregation in diabetic patients in relation to their metabolic control.
OBJECTIVE
To determine whether increased red blood cell adhesiveness/aggregation in diabetic patients is related to the extent of their metabolic control.


METHODS
We measured erythrocyte adhesiveness/aggregation in a group of 85 adult patients with diabetes mellitus by using citrated venous whole blood and a simple slide test. The erythrocyte adhesiveness/aggregation was determined by measuring the size of the spaces that are formed between the aggregated erythrocytes. We divided the patients into those with either low or high erythrocyte adhesiveness/aggregation values.


RESULTS
The erythrocyte adhesiveness/aggregation values of the two groups differed significantly in terms of their fibrinogen concentration, erythrocyte sedimentation rate, high sensitive C-reactive protein (CRP), total cholesterol and triglyceride concentrations. There was no difference between the two groups regarding the concentrations of HbA(1c). Logistic regression was applied to construct a model to predict the belonging of a patient in the low or high erythrocyte adhesiveness/aggregation group. A linear regression was applied to construct a model to predict the erythrocyte adhesiveness/aggregation values. Both models turned out to include gender, age, fibrinogen, triglyceride, retinopathy, coronary artery disease and age and gender interaction. Neither HbA(1c) nor CRP entered the models.


CONCLUSIONS
The degree of erythrocyte adhesiveness/aggregation and several variables of the acute-phase response in patients with diabetes mellitus are not directly related to the degree of metabolic control as evaluated by means of HbA(1c) concentration. Diabetic patients might benefit from rheological or anti-inflammatory interventions regardless of their metabolic control.
Elishkevitz
K
K
Departments of Internal Medicine D, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Fusman
R
R
Koffler
M
M
Shapira
I
I
Zeltser
D
D
Avitzour
D
D
Arber
N
N
Berliner
S
S
Rotstein
R
R
D000209:Acute-Phase Proteins / Q000096:biosynthesis; D001786:Blood Glucose / Q000378:metabolism*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002448:Cell Adhesion / Q000502:physiology; D002449:Cell Aggregation / Q000502:physiology; D003327:Coronary Disease / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D003925:Diabetic Angiopathies / Q000097:blood; D003930:Diabetic Retinopathy / Q000097:blood; D004912:Erythrocytes / Q000502:physiology*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D018056:Hemorheology / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D007958:Leukocyte Count; D008297:Male; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood
D000209:Acute-Phase Proteins; D001786:Blood Glucose; D014280:Triglycerides; D005340:Fibrinogen; D002097:C-Reactive Protein