Association among low whole blood viscosity, haematocrit, haemoglobin and diabetic retinopathy in subjects with type 2 diabetes

Irace, Concetta; Scarinci, Fabio; Scorcia, Vincenzo; Bruzzichessi, Donatella; Fiorentino, Raffaella; Randazzo, Giorgio; Scorcia, G; Gnasso, Agostino

doi:10.1136/bjo.2009.172601

Cited by 50 publications

(39 citation statements)

References 25 publications

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“…Individuals with anemia were more likely to develop DR than individuals without anemia, perhaps because of anemia-induced retinal hypoxia. Hypoxia may alter angiogenesis, capillary permeability, vasomotor response, and cell survival,[27] These results are consistent with those reported in the ETDRS, in which low hematocrit was identified as an independent risk-factor for the development of high-risk PDR and visual impairment. [28] Another large cross-sectional study showed that the odds ratio of having any retinopathy and also risk of severe retinopathy were higher for individuals with an hemoglobin level of < 12 g/dl, as compared with those level ≥ 12 g/dl.…”

Section: Discussionsupporting

confidence: 89%

Predictors of Diabetic retinopathy in Patients with type 2 Diabetes who have normoalbuminuria

Karoli¹,

Fatima²,

Shukla³

et al. 2013

Ann Med Health Sci Res

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Background:Microalbuminuria is an independent predictor of retinopathy, so absence of microalbuminuria may tend clinician not to screen for diabetic retinopathy (DR).Aim:The aim of our study was to estimate prevalence of DR in patients with type 2 diabetes who have normoalbuminuria, and to study predictors for DR, which can identify these high-risk individuals.Subjects and Methods:In a prospective cross-sectional study that included patients with type 2 DM and normoalbuminuria. Diagnosis of DR was made by a trained ophthalmologist based on the presence of clinical features in the fundus of both eyes following the International Clinical DR guidelines. The statistical analyses were performed using Statistical Package for the Social Sciences 15.0 version software (Chicago, IL, USA). The continuous variables expressed as means (SD and Student's t-test or Mann–Whitney test were used, as appropriate, to determine differences in them. Categorical variables were presented as percentage. The Pearson's Chi-square test or Fisher's exact test, as appropriate, was used to determine the differences in them.Results:A total of 226 patients with type 2 DM and normoalbuminuria were enrolled in the study that included 110 males (48.6%), and 116 females (51.4%) Mean (SD) duration of diabetes was 8.2 (5.6) years. DR of any grade was present in 49/226 (22%) patients. Of the patients with DR of any grade, 31/49 (63%) had mild non-proliferative diabetic retinopathy (NPDR) 10/49 (22%) had moderate to severe NPDR and 8/49 (15%) had PDR. Duration of diabetes (OR 1.01, 95% CI, 0.86-2.2, P = 0.04), higher systolic blood pressure (OR 2.2, 95% CI, 1.6-4.5, P = 0.01), low hemoglobin (OR 1.4, 95% CI, 0.45-2.9, P = 0.01), and a higher tertile of urinary albumin excretion rate (OR 4.12, 95% CI, 1.92-7.57, P = 0.001) had independently significant association with DR.Conclusion:The risk of DR exists in patients with type 2 diabetes even in normoalbuminuric individuals. Close monitoring is particularly needed if patients have longer duration of diabetes, hypertension, anemia, or high normal albuminuria.

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Section: Discussionsupporting

confidence: 89%

Predictors of Diabetic retinopathy in Patients with type 2 Diabetes who have normoalbuminuria

Karoli¹,

Fatima²,

Shukla³

et al. 2013

Ann Med Health Sci Res

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“…Important increases in BV have been reported in diabetic retinopathy, and it has been hypothesized that these changes lead to a prolonged reduction in the supply of oxygen and nutrients to the capillaries, causing the development of angiopathy (31,32). Once retinopathy has developed, its progression may be favored by a reduction in BV and hemoglobin (33). Overall, changes in viscosity in diabetic patients are accepted as common and as a result of the disease.…”

Section: Discussionmentioning

confidence: 99%

Blood Viscosity in Subjects With Normoglycemia and Prediabetes

et al. 2014

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OBJECTIVEBlood viscosity (BV) is higher in diabetic patients and might represent a risk factor for the development of insulin resistance and type 2 diabetes. However, data in subjects with normal glucose or prediabetes are missing. In the current study, we evaluated the relationship between BV and blood glucose in subjects with normal glucose or prediabetes. RESEARCH DESIGN AND METHODSEnrolled subjects were divided into three groups according to blood glucose: group A (n = 74), blood glucose <90 mg/dL; group B (n = 96), blood glucose ranging from 90 to 99 mg/dL; and group C (n = 94), blood glucose ranging from 100 to 125 mg/dL. BV was measured at 378C with a cone-plate viscometer at shear rates ranging from 225 to 22.5 s 21 . RESULTSBlood pressure, blood lipids, fibrinogen, and plasma viscosity were similar in the three groups. BMI and waist circumference were significantly increased in group C. Hematocrit (P < 0.05) and BV (P between 0.01 and 0.001) were significantly higher in groups B and C compared with group A. Blood glucose was significantly and inversely correlated with HDL cholesterol and directly with BMI, waist, hematocrit (r = 0.134), and BV (from 225 s 21 to 22.5 s 21 ; r ranging from 0.162 to 0.131). BV at shear rate 225 s 21 was independently associated with blood glucose. CONCLUSIONSThe current study shows a direct relationship between BV and blood glucose in nondiabetic subjects. It also suggests that, even within glucose values considered completely normal, individuals with higher blood glucose levels have increased BV comparable with that observed in subjects with prediabetes.

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“…Diabetic patients with retinopathy show higher blood viscosity than diabetics without retinopathy at both high and low shear rates [37]. However, another study came to the opposite conclusion [39]. Blood viscosity in diabetic patients who have experienced complications, such as microalbuminuria and nephropathy, is also higher than that in patients without such complications [40,41].…”

Section: Abnormalities In Blood Viscosity Associated With Diabetes Mementioning

confidence: 99%

Regulation of blood viscosity in disease prevention and treatment

et al. 2012

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Association among low whole blood viscosity, haematocrit, haemoglobin and diabetic retinopathy in subjects with type 2 diabetes

Cited by 50 publications

References 25 publications

Predictors of Diabetic retinopathy in Patients with type 2 Diabetes who have normoalbuminuria

Predictors of Diabetic retinopathy in Patients with type 2 Diabetes who have normoalbuminuria

Blood Viscosity in Subjects With Normoglycemia and Prediabetes

Regulation of blood viscosity in disease prevention and treatment

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