Blood Rheology and Cardiovascular Risk Factors in Type 1 Diabetes: Relationship with Microalbuminuria

Jay, Roger; Jones, Susan Y.; Hill, Caron; Richmond, W.; Viberti, Giancarlo; Rampling, M.W.; Betteridge, D. J.

doi:10.1111/j.1464-5491.1991.tb01674.x

Cited by 35 publications

(12 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…31 A positive relationship between plasma viscosity and LDL cholesterol, as well as between plasma viscosity and triglycerides, which may be explained by rheological effects of molecules of high molecular mass, are consistent with the results of other studies. 19,[32][33][34][35][36][37] The negative bivariate correlation between plasma viscosity and HDL cholesterol seems to be equivocal but is nevertheless consistent with the findings of other authors. 36 -38 However, the relationship remained no longer significant after performing the MLRA.…”

Section: Discussionsupporting

confidence: 80%

Relationship Between Plasma Viscosity and the Severity of Coronary Heart Disease

Junker

Heinrich

Ulbrich

et al. 1998

ATVB

View full text Add to dashboard Cite

Abstract-Several studies have indicated that plasma viscosity contributes to cardiovascular risk in men. So far, a significant relationship between plasma viscosity and the severity of coronary heart disease has not been found. Thus, the present study is the first to report on the relationship of plasma viscosity and the severity of coronary heart disease. In a collective of 1142 male myocardial infarction patients, plasma viscosity and additional laboratory parameters were determined. Atherosclerotic changes were quantified by coronary angiography. Patients were divided into groups without any, and with one to three stenosed vessels. We found a positive relationship between plasma viscosity and the severity of coronary heart disease, even after adjusting groups for age, fibrinogen, and use of diuretics. Mean plasma viscosity ranged from 1.141Ϯ0.035 mPa s in patients without stenosed vessels to 1.162Ϯ0.044 mPa s in patients who had three coronary vessels with stenoses Ͼ50%. Differences between the groups were significant (PϽ0.001 to 0.05), with two exceptions: differences between patients without any and with one stenosed vessel, as well as between patients with one and two stenosed vessels, did not reach the significance level. On the whole, we can give further support to the hypothesis that cardiovascular risk factors and coronary heart disease may be linked by plasma viscosity.(Arterioscler Thromb Vasc Biol. 1998;18:870-875.)Key Words: coronary heart disease Ⅲ myocardial infarction Ⅲ coronary risk factor Ⅲ blood rheology Ⅲ fibrinogen I n the prospective Caerphilly and Speedwell studies, as well as in the MONICA project, plasma viscosity was indicated as a predictive risk factor for CHD. 1,2 In other studies, high plasma viscosity was shown to lead to an increased risk of acute MI in patients with unstable angina pectoris. 3,4 Furthermore, a relationship of an early increase in plasma viscosity during acute MI and reinfarction or death was shown. 5 An elevation of plasma viscosity was found in patients with severe unstable angina pectoris compared with patients with stable angina pectoris and to healthy individuals. 6-8 Additionally, an elevated plasma viscosity in patients with stable angina pectoris, 9 even without coronary artery stenosis at angiography, 10 could be demonstrated. In the MONICA project, geographical differences in plasma viscosity between populations differing in the CHD event rates were found. 11 Evidently, plasma viscosity contributes to the cardiovascular risk and may be of special importance in areas of reduced blood flow, as commonly occurs in patients with advanced atherosclerosis. 12 Lowe et al 13 suggested that blood viscosity is related to the extension of CHD. The study that proposed this suggestion, however, consisted only of a small group of patients, and therefore the results require further investigation. Moreover, in this study, plasma viscosity was not significantly elevated in patients with extensive CHD compared with a control group and to patients with less severe CHD. Thu...

show abstract

Section: Discussionsupporting

confidence: 80%

Relationship Between Plasma Viscosity and the Severity of Coronary Heart Disease

Junker

Heinrich

Ulbrich

et al. 1998

ATVB

View full text Add to dashboard Cite

show abstract

“…The majority of studies have reported that the development of microalbuminuria/overt diabetic nephropathy is associated with a significant increase in plasma fibrinogen levels, and that a correlation exists between levels and the rate of urinary albumin excretion [14,16,17,[24][25][26][27][28]. Other studies have, however, found no difference in levels between diabetic patients with and without microalbuminuria [18,29,30].…”

Section: Type 1 Diabetes and Fibrinogenmentioning

confidence: 74%

Fibrinogen and Fibrin Clot Structure in Diabetes

Dunn

Ariëns²

2004

Herz

View full text Add to dashboard Cite

Diabetes is associated with an increased risk of developing cardiovascular disease, which is not fully accounted for by the accumulation of classic cardiovascular risk factors in patients. Recent evidence has demonstrated fibrinogen to be a powerful independent risk marker for cardiovascular disease in the general population, and it is also likely to contribute toward the increased atherosclerotic risk in diabetes. The etiology of hyperfibrinogenemia in diabetes is likely to be multifactorial, and at present the mechanisms involved have not been clarified. However, insulin, insulin resistance and inflammation are likely to be involved, especially in type 2 diabetes. The influence of diabetes in determining an individual's atherothrombotic risk is likely to extend beyond that of elevated fibrinogen levels, and may also act via changes in the structure and function of the fibrin clot that forms. Further research is needed to determine the mechanisms underlying these changes, which may lead to development of future interventions to reduce the excessive vascular risk associated with this disease.

show abstract

“…It has long been recognised that plasma fibrinogen concentration is elevated in diabetes [40] but a relationship with nephropathy has not always been apparent [41]. Fibrinogen could contribute to the development of nephropathy in a variety of ways: it is the substrate for thrombin in blood coagulation, and animal studies indicate that the fibrinogen concentration at the initiation of coagulation influences the amount of fibrin deposited [42]; in this context it is relevant that low-dose heparin therapy was recently shown to reduce urinary albumin excretion rate in IDDM [43].…”

Section: Discussionmentioning

confidence: 99%

Fibrinogen and von Willebrand factor in IDDM: relationships to lipid vascular risk factors, blood pressure, glycaemic control and urinary albumin excretion rate: the EURODIAB IDDM complications study

et al. 1997

View full text Add to dashboard Cite

The pathogenic mechanisms underlying the development of microvascular complications in insulin-dependent diabetes mellitus (IDDM) remain obscure despite the fact that retinopathy develops in the majority [1][2][3], and nephropathy in around 30 % [3,4]. Although duration of diabetes and poor glycaemic control are established risk factors, they appear to account for only a proportion of an individual's risk [5]. We have recently demonstrated that, in subjects with retinopathy but not those without, mean urinary albumin excretion rate increases steeply when the mean diastolic blood pressure rises above 75 mmHg. It thus appears that members of a subgroup of diabetic subjects may have abnormal renal vulnerability Diabetologia (1997) Summary The interrelationships between fibrinogen, von Willebrand factor, a marker of vascular endothelial cell damage, and serum lipids were explored in well-characterised subjects with insulin-dependent diabetes mellitus. The 2091 subjects were enrolled into a cross-sectional, clinic-based study of complications, from 16 European countries: the EURODIAB IDDM Complications study. The anticipated significant relationships between both plasma fibrinogen and plasma von Willebrand factor concentrations and age and glycaemic control, and between fibrinogen and body mass index, were noted. Fibrinogen, adjusted for age and glycated haemoglobin concentration, was also related to smoking habits and was higher in the quartiles with highest systolic and diastolic blood pressures. There was a clustering of vascular risk factors, with a positive relationship between plasma fibrinogen and serum triglyceride concentrations in both genders and between fibrinogen and total cholesterol in males. An inverse relationship between fibrinogen and high density lipoprotein cholesterol was also apparent in males. A prominent feature was a positive relationship between both fibrinogen and von Willebrand factor and albumin excretion rate (p < 0.001 and p < 0.003 respectively) in those with retinopathy but not in those without this complication. In view of previous observations on blood pressure and albuminuria in these subjects the findings are consistent with the hypothesis that microalbuminuria and increased plasma von Willebrand factor are due to endothelial cell perturbation in response to mildly raised blood pressure in subjects with retinopathy. Fibrinogen may also contribute to microvascular disease and its relationships to lipid vascular risk factors suggest a possible pathogenic role in arterial disease in diabetes. [Diabetologia (1997) to mildly raised blood pressure and that retinopathy is a close correlate of this risk [6].von Willebrand factor (vWF) is synthesised by vascular endothelial cells and megakaryocytes and an increased concentration in plasma can serve as a marker of endothelial cell damage [7][8][9]. Such an increase is a feature of diabetic nephropathy [10]. Recent studies in small numbers of subjects with IDDM suggest that vWF is a sensitive marker of incipient nephropathy and that a r...

show abstract

Blood Rheology and Cardiovascular Risk Factors in Type 1 Diabetes: Relationship with Microalbuminuria

Cited by 35 publications

References 37 publications

Relationship Between Plasma Viscosity and the Severity of Coronary Heart Disease

Relationship Between Plasma Viscosity and the Severity of Coronary Heart Disease

Fibrinogen and Fibrin Clot Structure in Diabetes

Fibrinogen and von Willebrand factor in IDDM: relationships to lipid vascular risk factors, blood pressure, glycaemic control and urinary albumin excretion rate: the EURODIAB IDDM complications study

Contact Info

Product

Resources

About