Association between low Whole Blood Viscosity, Hematocrit, Hemoglobin and Diabetic Retinopathy in subjects with type 2 diabetes
Résumé
Abstract Objectives: Hemorheological variables influence endothelial function through the release of several factors. Clinical studies have described an association between blood viscosity, hematocrit, hemoglobin and macro-angiopathy. Few data are reported about the association between hemorheological variables and micro-angiopathy. Aim of the present study was to evaluate the association between these variables and retinopathy in subjects with type 2 diabetes. Methods: We recruited 111 males, 79 postmenopausal females, and 95 healthy age and sex-matched controls. Hematocrit and hemoglobin were measured by standard methods. Blood viscosity was calculated according to the formula [0.12 x hematocrit] + [0.17 x (plasma proteins-2.07)]. Subjects were grouped according to the presence or absence of DR, while the severity of retinopathy was classified according to the ETDRS scale. Results: Hemoglobin, hematocrit and whole blood viscosity were significantly lower in subjects with retinopathy compared to subjects without retinopathy in both sexes. These variables significantly decreased with increasing severity of retinopathy. A multiple logistic regression analysis confirmed the independent inverse association between viscosity, hematocrit, hemoglobin, and retinopathy (p<0.01). Conclusion: Our results demonstrate the association between low viscosity, hemoglobin, hematocrit, and diabetic retinopathy. The mechanisms responsible for this association can be hypothesized. Reduced haemoglobin might cause direct organ damage. Low blood viscosity, through the reduction of shear stress, might inhibit the anti-atherogenic functions of endothelial cells.
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