ELEVATION OF VISCOELASTICITY OF BLOOD IN NON-COAGULATIVE AND COAGULATIVE STATE IN DIABETES, AS INDEXES OF INCREASING THE INCIDENCE OF AGGRAVATION OF MICROANGIOPATHY

The pathogenesis of diabetic microangiopathy has been considered to be closely related with abnormal viscous blood flow and hypercoagulabili ty in microcirculation. This study aims to find good indices for forec asting the incidence of aggravation of microangiopathy in diabetes. Tw o kinds of devices have been applied to investigate the theologic prop erty in diabetics, especially the viscoelasticity in anticoagulation a nd clotting state of blood. OP-Rheometer system for non-clotting blood and a viscoelastorecorder (VER) for clotting process were used to obs erve each significance of viscoelasticity for contribution to microang iopathy respectively. The abnormality in viscoelasticity of the blood was well correlated with plasma fibrinogen and the severity of microan giopathy. In VER maximum value of dynamic rigidity modulus (G'm) was a good index for hypercoagulable state which includes high plasma visco sity, the increased plasma fibrinogen, high red cell aggregation and t he severity of retinopathy. To correlate in vivo study with in vitro e xamination tests, we observe the intravascular erythrocyte aggregation (IEA) in bulbar conjunctiva by a biomicroscopy. There was a good corr elation of IEA to G'm and other hemorheological factors. In conclusion , elevation of both viscoelasticity of blood and clotting process (G'm ) and high grade IEA suggest the increase of the incidence of aggravat ion on diabetic microangiopathy. Copyright (C) 1996 Elsevier Science L td