Impairment of Erythrocyte Deformability Observed in Type 2 Diabetic Patients with Clustering Diabetic Complications
ISTH Academy. Maruyama T. Jul 9, 2019; 264689; PB1499 Topic: Blood Cells & Vessel Wall
Toru Maruyama
Toru Maruyama
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Impairment of Erythrocyte Deformability Observed in Type 2 Diabetic Patients with Clustering Diabetic Complications

T. Maruyama1, T. Arita2, S. Moriyama2, K. Irie2, T. Yokoyama2, M. Fukata2, K. Odashiro2, K. Akashi2, T. Fujino3
1Kyushu University, Campus Life Health Center, Fukuoka, Japan, 2Kyushu University, Department of Medicine, Fukuoka, Japan, 3BOOCS Clinic, Fukuoka, Japan

Main Topic: Immunothrombosis and Vascular Biology
Category: Blood Cells & Vessel Wall

Background: Hemorheologic and microvascular dysfunction are interdependent in patients with type 2 diabetes mellitus especially associated with diabetic complications. However, exact mechanisms explaining this interaction is unclear.
Aims: This study aimed to investigate the impairment of erythrocyte deformability under the concurrent estimation of erythrocyte density profile and recording electrocardiogram (ECG), since QT interval prolongation reflects microvascular as well as autonomic dysfunction in diabetic patients.
Methods: The erythrocyte deformability and density profiles were investigated on the day of ECG recording in diabetic (n = 215) and non-diabetic control (n = 88) groups of outpatients after obtaining infomed consent. Deformability was estimated by specific filtration method and so was density distribution by phthalate ester separation technique. Heart rate correction of QT interval (QTc interval) was performed by Bazett's formula. QTc interval and coefficient of variance in RR interval (CVRR), as a measure of autonomic function, were obtained by digital ECG recorder.
Results: The mean erythrocyte deformability in diabetic group was marginally (p = 0.067) impaired relative to that in control group, but the difference was significant in comparison of diabetic smokers vs. non-smokers (p = 0.045) and by classifying diabetic complications (p = 0.047). Peak density of diabetic erythrocyte population was greater than that of control erythrocytes. In multivariate analysis, impaired diabetic erythrocyte deformability was dependent on HbA1c (p = 0.022), and this impairment showed weakly negative correlation to the QTc prolongation (p = 0.068), which was explained mostly by CVRR (p < 0.001).
Conclusions: Erythrocyte deformability is impaired in diabetic patients with smoking and clustering diabetic complications. HbA1c is associated with peak erythrocyte density, and dense diabetic erythrocytes are considered to be one of the causes of this impairment. QTc interval showed weakly negative correlation to erythrocyte deformability, implying hemorheologic and microvascular interaction leading to the derangement of microcirculation in diabetic patients.

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