Comparative study between microvascular tone regulation and rheological properties of blood in patients with type 2 diabetes mellitus

Comprehensive study of the rheological status and intensity of oxidative stress during the progression of type 2 diabetes mellitus to prevent its complications

BACKGROUND

Prevention of Type 2 diabetes mellitus (T2DM) requires a modifying effect on the pathological processes inducing the β-cell dysfunction.

OBJECTIVES

the comprehensive study of the violation of rheological parameters in patients with different stages of diabetes and identification of possible links between these alterations with the intensity of the oxidative stress in the patient's body.

METHODS

60 patients with IR, prediabetes, T2DM and healthy volunteers were included. Full range of the rheological parameters of the patients' blood - the indicators of erythrocytes aggregation index (EAI), the relative deformability of the erythrocytes membranes (ERDI), blood plasma viscosity (BPV), and oxidative stress intensity (OSI) were examined.

RESULTS

In patients with insulin resistance (IR), prediabetes, and T2DM the ERDI was statistically significantly lower and BPV - higher compared to control; a significant increase in EAI was detected in the patient group with prediabetes and T2DM compared to the control.

CONCLUSION

The level of rheological disorders in patients increases with the increase of the level of carbohydrate metabolism disorders and intensity of oxidative stress and reaches a maximum during manifested diabetes. Diagnosis of hemorheological disorders and OSI in T2DM can serve as an early marker of target organ damage possibility.

Thermal Analysis of Blood Flow Alterations in Human Hand and Foot Based on Vascular-Porous Media Model

Microvascular and Macrovascular diseases are serious complications of diabetic mellitus, which significantly affect the life quality of diabetic patients. Quantitative description of the relationship between temperature and blood flow is considerably important for non-invasive detection of blood vessel structural and functional lesions. In this study, thermal analysis has been employed to predict blood flow alterations in a foot and a cubic skin model successively by using a discrete vessel-porous media model and further compared the blood flows in 31 diabetic patients. The tissue is regarded as porous media whose liquid phase represents the blood flow in capillaries and solid phase refers to the tissue part. Discrete vascular segments composed of arteries, arterioles, veins, and venules were embedded in the foot model. In the foot thermal analysis, the temperature distributions with different inlet vascular stenosis were simulated. The local temperature area sensitive to the reduction of perfusion was obtained under different inlet blood flow conditions. The discrete vascular-porous media model was further applied in the assessment of the skin blood flow by coupling the measured skin temperatures of diabetic patients and an inverse method. In comparison with the estimated blood flows among the diabetic patients, delayed blood flow regulation was found in some of diabetic patients, implying that there may be some vascular disorders in these patients. The conclusion confirms the one in our previous experiment on diabetic rats. Most of the patients predicted to be with vascular disorders were diagnosed as vascular complication in clinical settings as well, suggesting the potential applications of the vascular-porous media model in health management of diabetic patients.

The Effect of Glucose and Poloxamer 188 on Red-Blood-Cell Aggregation

Glucose metabolism disorders contribute to the development of various diseases. Numerous studies show that these disorders not only change the normal values of biochemical parameters but also affect the mechanical properties of blood. To show the influence of glucose and poloxamer 188 (P188) on the mechanical properties of a red-blood-cell (RBC) suspension, we studied the aggregation of the cells. To show the mechanisms of the mechanical properties of blood, we studied the effects of glucose and poloxamer 188 (P188) on red-blood-cell aggregation. We used a model in which cells were suspended in a dextran 70 solution at a concentration of 2 g/dL with glucose and P188 at concentrations of 0–3 g/dL and 0–3 mg/mL, respectively. RBC aggregation was determined using an aggregometer, and measurements were performed every 4 min for 1 h. Such a procedure enabled the incubation of RBCs in solution. The aggregation index determined from the obtained syllectograms was used as a measure of aggregation. Both the presence of glucose and that of P188 increased the aggregation index with the incubation time until saturation was reached. The time needed for the saturation of the aggregation index increased with increasing glucose and P188 concentrations. As the concentrations of these components increased, the joint effect of glucose and P188 increased the weakening of RBC aggregation. The mechanisms of the observed changes in RBC aggregation in glucose and P188 solutions are discussed.

Bridging the gap between basic research on microcirculation and clinical world: The translational marriage between engineering and medicine

The words "Translational" and "Medicine" have been recently coupled to indicate a combination of disciplines, resources, expertise, and techniques aimed at enhancing prevention, diagnosis, and therapies. As stated in 2015 by the European Society for Translational Medicine, translational medicine is "an interdisciplinary branch of the biomedical field supported by three main pillars: benchside, bedside and community". By definition, Translational Medicine is a highly interdisciplinary field, which gathers several specialties aimed at improving the global healthcare system.With regard to the assessment of the microcirculatory function, it is worthwhile to mention the growing interest from both basic research and clinical practice. Microcirculation is where the exchange of substances between blood and tissues takes place. Thus, it plays a key role in the pathophysiology of many diseases. Nonetheless, a gap does exist between the theoretical analysis of the microcirculatory function and its clinical exploitation. This gap can be due to the weak dissemination of analytical methods and theoretical results within the clinical community, which also delays the establishment of specific operative guidelines.This paper aims at encouraging, and possibly accelerating, the translation of basic research outcomes on microcirculatory function assessment into clinical applications.

Obesity, blood rheology and angiogenesis

Adipose tissue is actively involved in angiogenesis through secretion of biologically active substances. This topic has been the subject of many recent publications concerning the pathophysiology and treatment of obesity. We discuss the relationship between obesity, angiogenesis and blood rheology.