Wiewiora Maciej, Piecuch Jerzy, Glûck Marek, Slowinska-Lozynska Ludmila, Sosada Krystyn
Department of General and Bariatric Surgery and Emergency Medicine in Zabrze, Medical University of Silesia, Katowice, Poland.
Chair and Department of Biophysics, Medical University of Silesia, Katowice, Poland.
Clin Hemorheol Microcirc. 2014;58(4):543-50. doi: 10.3233/CH-141814.
The aim of this study was to evaluate the effects of the obesity degree on red blood cell aggregation and deformability. We studied 56 obese patients before weight loss surgery who were divided into two groups: morbid obesity and super obesity. The aggregation and deformability of RBCs were evaluated using a Laser-assisted Optical Rotational Cell Analyzer (Mechatronics, the Netherlands). The following parameters specific to the aggregation process were estimated: aggregation index (AI), aggregation half-time (t1/2) and threshold shear rate (γthr). RBC deformability was expressed as erythrocyte elongation (EI), which was measured at 18.49 Pa and 30.2 Pa shear stresses. Super obese patients presented significantly higher AI (P < 0.05) and γthr (P < 0.05) and significantly lower t1/2 (P < 0.05) compared with morbidly obese individuals. Multivariate analyses showed that fibrinogen (β 0.46, P < 0.01 and β 0.98, P < 0.01) and hematocrit (β 0.38, P < 0.05 and β 1.01, P < 0.01) independently predicted the AI in morbidly obese and super obese patients. Fibrinogen (β -0.4, P < 0.05 and β -0.91, P < 0.05) and hematocrit (β -0.38, P < 0.05 and β -1.11, P < 0.01) were also independent predictors of the t1/2 in both obese groups. The triglyceride level (β 0.32, P < 0.05) was an independent predictor of the t1/2 in the morbidly obese group. No differences in EI were observed between obese subjects. Multivariate analyses showed that the triglyceride level independently predicted EI at 18.49 Pa (β -0.42, P < 0.05 and β -0.53, P < 0.05) and 30.2 Pa (β -0.44, P < 0.01 and β -0.49, P < 0.05) in both obese groups. This study indicated that the obesity degree of patients who qualify for bariatric surgery affects RBC aggregation properties, but it does not indicate the reasons for this difference. Further studies are needed to determine factors associated with hyperaggregation in super obesity.
本研究的目的是评估肥胖程度对红细胞聚集性和变形性的影响。我们研究了56例减肥手术前的肥胖患者，他们被分为两组：病态肥胖和超级肥胖。使用激光辅助光学旋转细胞分析仪（荷兰梅卡托尼克斯公司）评估红细胞的聚集性和变形性。估计了以下特定于聚集过程的参数：聚集指数（AI）、聚集半衰期（t1/2）和阈值剪切率（γthr）。红细胞变形性用红细胞伸长率（EI）表示，在18.49 Pa和30.2 Pa的剪切应力下进行测量。与病态肥胖个体相比，超级肥胖患者的AI（P < 0.05）和γthr（P < 0.05）显著更高，t1/2（P < 0.05）显著更低。多变量分析表明，纤维蛋白原（β 0.46，P < 0.01和β 0.98，P < 0.01）和血细胞比容（β 0.38，P < 0.05和β 1.01，P < 0.01）分别独立预测病态肥胖和超级肥胖患者的AI。纤维蛋白原（β -0.4，P < 0.05和β -0.91，P < 0.05）和血细胞比容（β -0.38，P < 0.05和β -1.11，P < 0.01）也是两组肥胖患者t1/2的独立预测因素。甘油三酯水平（β 0.32，P < 0.05）是病态肥胖组t1/2的独立预测因素。肥胖受试者之间未观察到EI的差异。多变量分析表明分析表明，甘油三酯水平分别独立预测两组肥胖患者在18.49 Pa（β -0.42，P < 0.05和β -0.53，P < 0.05）和30.2 Pa（β -0.44，P < 0.01和β -0.49，P < 0.05）时的EI。本研究表明，符合减肥手术条件的患者的肥胖程度会影响红细胞聚集特性，但未表明造成这种差异的原因。需要进一步研究以确定与超级肥胖中高聚集性相关的因素。
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