Sickle Cell Trait Worsens Oxidative Stress, Abnormal Blood Rheology, and Vascular Dysfunction in Type 2 Diabetes.
OBJECTIVE
It is predicted that Africa will have the greatest increase in the number of patients with type 2 diabetes mellitus (T2DM) within the next decade. T2DM patients are at risk for cardiovascular disorders. In Sub-Saharan African countries, sickle cell trait (SCT) is frequent. Despite the presence of modest abnormalities in hemorheology and oxidative stress, SCT is generally considered a benign condition. Little is known about vascular function in SCT, although recent studies demonstrated an increased risk of cardiovascular disorders, including venous thromboembolism, stroke, and chronic kidney disease. We hypothesized that SCT could accentuate the vascular dysfunction observed in T2DM.


METHODS
The current study, conducted in Senegal, compared vascular function, hemorheological profile, and biomarkers of oxidative stress, inflammation, and nitric oxide metabolism in healthy individuals (CONT), subjects with T2DM or SCT, and patients with both T2DM and SCT (T2DM-SCT).


RESULTS
Flow-mediated dilation was blunted in individuals with T2DM, SCT, and T2DM-SCT compared with CONT, with vascular dysfunction being most pronounced in the latter group. Carotid-femoral pulse wave velocity measurements demonstrated increased arterial stiffness in T2DM-SCT. Oxidative stress, advanced glycation end products, and inflammation (interleukin-1β) were greater in patients with T2DM-SCT compared with the other groups. Blood viscosity was higher in individuals with TD2M, SCT carriers, and individuals with T2DM-SCT, and the values were further increased in the latter group.


CONCLUSIONS
Our results demonstrate severe biological abnormalities and marked vascular dysfunction in patients with both T2DM and SCT. SCT should be viewed as a risk factor for further cardiovascular disorders in individuals with T2DM.
Laboratoire de Physiologie et Explorations Fonctionnelles, FMPO, Université Cheikh Anta Diop de Dakar (UCAD), Dakar, Senegal.
Mor
M
Diaw
CRIS EA 647 Laboratory, Team Vascular Biology and Red Blood Cell, University Claude Bernard Lyon 1, Villeurbanne, France Institut Universitaire de France, Paris, France Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.
Vincent
V
Pialoux
CRIS EA 647 Laboratory, Team Vascular Biology and Red Blood Cell, University Claude Bernard Lyon 1, Villeurbanne, France Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.
Cyril
C
Martin
Laboratoire de Physiologie et Explorations Fonctionnelles, FMPO, Université Cheikh Anta Diop de Dakar (UCAD), Dakar, Senegal UMI 3189, Environnement, Sante, Sociétés, CNRS, CNRST, Université Bamako-UCAD, Dakar, Senegal.
Abdoulaye
A
Samb
Laboratoire d'Hémato-Immunologie, FMPO, UCAD, Dakar, Senegal.
Saliou
S
Diop
CRIS EA 647 Laboratory, Team Vascular Biology and Red Blood Cell, University Claude Bernard Lyon 1, Villeurbanne, France Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.
Camille
C
Faes
CRIS EA 647 Laboratory, Team Vascular Biology and Red Blood Cell, University Claude Bernard Lyon 1, Villeurbanne, France Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France.
Pauline
P
Mury
Laboratoire de Biochimie et de Biologie Moléculaire, FMPO, UCAD, Dakar, Senegal.
Niama
N
Sall Diop
Clinique Médicale II, Centre Hospitalier Abass Ndao, Dakar, Senegal.
Saïd-Norou
SN
Diop
Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France UMR INSERM 970, Université Paris Descartes, Paris, France Service de Médecine Interne, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France.
Brigitte
B
Ranque
Clinique Médicale II, Centre Hospitalier Abass Ndao, Dakar, Senegal.
Maïmouna Ndour
MN
Mbaye
Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Nigel S
NS
Key
CRIS EA 647 Laboratory, Team Vascular Biology and Red Blood Cell, University Claude Bernard Lyon 1, Villeurbanne, France Institut Universitaire de France, Paris, France Laboratory of Excellence in Red Blood Cell (LABEX GR-Ex), PRES Sorbonne, Paris, France philippe.connes@univ-lyon1.fr.
Philippe
P
Connes
D000328:Adult; D001809:Blood Viscosity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D063177:Pulse Wave Analysis; D012212:Rheology; D012307:Risk Factors; D012675:Senegal; D012805:Sickle Cell Trait / Q000097:blood / Q000503:physiopathology*; D014652:Vascular Diseases / Q000097:blood / Q000503:physiopathology*