INCREASED ERYTHROCYTE AGGREGATION IN INSULIN-DEPENDENT DIABETES-MELLITUS AND ITS RELATIONSHIP TO PLASMA FACTORS - A MULTIVARIATE-ANALYSIS

Red blood cell aggregation in vitro (kinetics and shear resistance) wa s studied in 13 healthy controls and 13 type (insulin-dependent) diabe tic patients free of severe degenerative complications who were matche d for age, sex, and body mass index. Measurements were performed with a device that analyzes the laser light backscattered by a blood suspen sion. Both the velocity of rouleau formation and the cohesion of the r ouleau network were significantly increased in diabetic patients. Plas ma viscosity and whole-blood viscosity measured at low shear rate (0.9 5 s(-1)) were also significantly elevated in the diabetic group. Multi variate analyses of the whole population sample and the diabetic patie nts confirmed the influence of plasma proteins on the kinetics of aggr egation. Fibrinogen levels, which were close to normal, affected mainl y the shear resistance of the aggregates. Triglyceride and apolipoprot ein (ape) B levels and indexes of metabolic control or protein glycati on (fasting blood glucose and fructosamine) also appeared to influence markedly both the kinetics of rouleau formation and the cohesion of t he rouleau networks. These theological abnormalities occurred in diabe tic patients before the appearance of any severe degenerative complica tions. We suggest that these theological abnormalities are linked to p lasma or erythrocyte factors, and are not due to angiopathy. Copyright (C) 1994 by W.B. Saunders Company