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Rheological and microvascular parameters in diabetic peripheral neuropathy
M J Young1, J L Bennett, S A Liderth
1University Department of Medicine, Manchester Royal Infirmary, U.K.
Clinical Science (London, England : 1979)
|March 1, 1996
Summary
Diabetic peripheral neuropathy is linked to altered blood flow and viscosity, even without other complications. These changes in erythrocyte aggregation and fibrinogen suggest underlying haemorheological issues in neuropathic patients.
Area of Science:
- Cardiovascular medicine
- Neurology
- Diabetology
Background:
- Diabetic peripheral neuropathy (DPN) affects numerous patients, but the underlying causes, particularly rheological changes, are not fully understood.
- Existing research often overlooks DPN in the absence of other common diabetic complications like retinopathy or proteinuria.
- Haemorheology, the study of blood flow properties, may offer insights into DPN pathophysiology.
Purpose of the Study:
- To investigate rheological and microvascular differences in neuropathic diabetic patients compared to non-neuropathic diabetics and healthy controls.
- To determine if haemorheological changes occur independently of other diabetic complications.
- To explore the association between rheological parameters and microvascular function in DPN.
Main Methods:
- Three matched groups were studied: non-diabetic controls (C), non-neuropathic diabetics (D), and neuropathic diabetics (N).
- Neuropathy was defined by peroneal nerve conduction velocity (< 40 ms-1).
- Measurements included transcutaneous oxygen, laser Doppler flux, erythrocyte aggregation, plasma viscosity, plasma fibrinogen, and whole-blood viscosity at various shear rates.
Main Results:
- No significant rheological differences were found between uncomplicated diabetics and controls, though nerve conduction was reduced in diabetics.
- Neuropathic diabetics showed significantly higher erythrocyte aggregation, plasma viscosity, and fibrinogen levels compared to controls.
- Microvascular flow (transcutaneous oxygen and laser Doppler flux) was reduced in neuropathic diabetics compared to controls, and whole-blood viscosity was elevated.
Conclusions:
- Rheological alterations, including increased erythrocyte aggregation and viscosity, are associated with diabetic peripheral neuropathy.
- These haemorheological changes occur even in the absence of common diabetic complications.
- The findings suggest that impaired blood flow contributes to the development and progression of DPN.