BLOODS INCREASED TRANSIENT RESISTANCE IN DIABETES IS GENERATED BY ITSFIBRINOGEN AND GLOBULIN CONTENT

Blood manifests a rapidly recovered form of thixotropy called transien t resistance. Thixotropy and transient resistance are closely related to each other. Both are elevated in diabetes. Transient resistance has been shown to be mediated by the need to restore the orientation of i ndividual red blood cells as flow becomes reestablished. In resting bl ood, the red cells start as rouleaux that must be disrupted to start f low. The red cells are able to form enough structure between heartbeat s to generate a sharp resistance peak as blood flows in arteries durin g the next systole. Transient resistance measures this peak load in ar teries due to the predilection of red blood cells to aggregate. Transi ent resistance and plasma fibrinogen are both elevated in diabetes. A recent analysis of Diabetes Control & Complications Trial (DCCT) patie nts has shown a strong relation between fibrinogen and total globulin levels and the development of diabetic eye and kidney complications. T he complications were measured as major end points in that study. DCCT blood viscosity and thixotropy results have already been reported in this journal. They were developed in a study of 45 DCCT patients in Ta mpa. Both fibrinogen and hemoglobin Ale levels were shown to influence low shear rate blood viscosity. Total globulin is not elevated in dia betes. Its linkage to the development of diabetic complications theref ore has particular interest. Some details of the already reported stud y have greater interest now than when the report was prepared. They ar e reported now because of their relation to the recently discovered ro les of fibrinogen and total globulin levels. The new findings of inter est are a close relation between low shear rate blood viscosity and tr ansient resistance. Fibrinogen influences both. Total globulin influen ces transient resistance but not low shear rate viscosity. Transient r esistance is made higher by fibrinogen and total globulin levels linke d to diabetic complications and generates a peak systolic flow resista nce. Copyright (C) 1996 Elsevier science Ltd