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符合减肥手术条件的患者血液流变学改变与代谢综合征临床诊断之间的关联。

Association between hemorheological alteration and clinical diagnosis of metabolic syndrome among patients qualified for bariatric surgery.

作者信息

Wiewiora Maciej, Slowinska-Lozynska Ludmila, Glück Marek, Piecuch Jerzy, Sosada Krystyn, Monkos Karol

机构信息

Department of General and Bariatric Surgery and Emergency Medicine in Zabrze, Medical University of Silesia, Katowice, Poland.

Chair and Department of Biophysics, Faculty of Medicine in Zabrze, Medical University of Silesia, Katowice, Poland.

出版信息

Clin Hemorheol Microcirc. 2014;56(2):101-9. doi: 10.3233/CH-2012-1642.

Abstract

This study presents the association between metabolic syndrome and hemorheological parameters among obese patients qualified for bariatric surgery. We studied 73 morbidly obese patients who were qualified for bariatric surgery. Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). RBC aggregation was measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). The following parameters for the aggregation process were estimated: aggregation index (AI), amplitude (AMP), aggregation half-time (t1/2), threshold shear rate (γthr), the fast (Tfast) and the slow (Tslow) component. Metabolic syndrome was defined according to the Adult Treatment Panel III and International Diabetes Federation criteria. The obese presented differences in all rheological properties compared to control, regardless of clinical diagnosis of metabolic syndrome, except that whole blood viscosity was higher only in the obese metabolic syndrome group. No differences among the obese with and without metabolic syndrome were observed except in hematocrit. Whole blood viscosity and corrected blood viscosity correlated positively with WHR and BMI. AI, γthr, Tslow correlated positively with BMI, WHR, total cholesterol level and low-density lipoproteins. Negative correlation presented t1/2 with BMI, WHR, fibrinogen, total cholesterol level and low-density lipoproteins. The study showed that morbid obesity is associated with hemorheological disturbances independently of clinical diagnosis of metabolic syndrome.

摘要

本研究呈现了符合减重手术条件的肥胖患者中代谢综合征与血液流变学参数之间的关联。我们研究了73名符合减重手术条件的病态肥胖患者。使用锥板式粘度计(布鲁克菲尔德DV-II)进行血液和血浆粘度测量。使用激光辅助光学旋转细胞分析仪(LORCA)测量红细胞聚集。估计了聚集过程的以下参数:聚集指数(AI)、振幅(AMP)、聚集半衰期(t1/2)、阈值剪切率(γthr)、快速(Tfast)和慢速(Tslow)成分。根据成人治疗小组III和国际糖尿病联盟标准定义代谢综合征。无论代谢综合征的临床诊断如何,肥胖患者与对照组相比,所有血液流变学特性均存在差异,只是全血粘度仅在肥胖代谢综合征组中较高。除血细胞比容外,未观察到有或无代谢综合征的肥胖患者之间存在差异。全血粘度和校正血粘度与腰臀比(WHR)和体重指数(BMI)呈正相关。AI、γthr、Tslow与BMI、WHR、总胆固醇水平和低密度脂蛋白呈正相关。t1/2与BMI、WHR、纤维蛋白原、总胆固醇水平和低密度脂蛋白呈负相关。该研究表明,病态肥胖与血液流变学紊乱有关,独立于代谢综合征的临床诊断。

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