Park Kyu Hwan, Kim Ung, Choi Kang Un, Nam Jong Ho, Lee Jung Hee, Lee Chan Hee, Son Jang Won, Park Jong Seon, Shin Dong Gu, Won Kyu Chang, Moon Jun Sung, Kim Yu Kyung, Suh Jang Soo
Department of Internal Medicine, Daegu Veterans Hospital, Daegu, Korea.
Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
Diabetes Metab J. 2018 Apr;42(2):155-163. doi: 10.4093/dmj.2018.42.2.155.
Hemorheologic indices are known to be related to vascular complications in variable clinical settings. However, little is known about the associations between hemorheologic parameters and acute myocardial infarction (AMI) in type 2 diabetes mellitus (T2DM). The purpose of this study was to demonstrate the changes of hemorheologic environment inside of blood using hemorheologic parameters, especially the elongation index (EI) and critical shear stress (CSS) in diabetics with versus without AMI.
A total of 195 patients with T2DM were enrolled. Patients were divided into the study group with AMI (AMI+, n=77) and control group (AMI-, n=118) who had no history of coronary artery disease. Hemorheologic parameters such as EI and CSS were measured and compared between the two groups.
The EI was lower (30.44%±1.77% in AMI+ and 31.47%±1.48% in AMI-, P<0.001) but the level of CSS was higher (316.13±108.20 mPa in AMI+ and 286.80±85.34 mPa in AMI-, P=0.040) in the AMI+. The CSS was significantly related to the erythrocyte sedimentation rate (R²=0.497, P<0.001) and use of dipeptidyl peptidase-4 inhibitors (R²=0.574, P=0.048).
Diabetics with AMI resulted in adverse hemorheologic changes with lower EI and higher CSS compared to diabetic subjects without AMI. Evaluation of the hemorheologic parameters may provide valuable supplementary information for managing patients with AMI and T2DM.
血液流变学指标在不同临床环境中与血管并发症相关。然而，关于血液流变学参数与2型糖尿病（T2DM）急性心肌梗死（AMI）之间的关联知之甚少。本研究旨在利用血液流变学参数，特别是伸长指数（EI）和临界剪切应力（CSS），来证明有或无AMI的糖尿病患者血液内部血液流变学环境的变化。
共纳入195例T2DM患者。患者被分为有AMI的研究组（AMI+，n=77）和无冠状动脉疾病病史的对照组（AMI-，n=118）。测量并比较两组的血液流变学参数，如EI和CSS。
AMI+组的EI较低（AMI+组为30.44%±1.77%，AMI-组为31.47%±1.48%，P<0.001），但CSS水平较高（AMI+组为316.13±108.20 mPa，AMI-组为286.80±85.34 mPa，P=0.040）。CSS与红细胞沉降率显著相关（R²=0.497，P<0.001）以及二肽基肽酶-4抑制剂的使用相关（R²=0.574，P=0.048）。
与无AMI的糖尿病患者相比，有AMI的糖尿病患者会导致不良的血液流变学变化，表现为EI较低和CSS较高。评估血液流变学参数可能为管理AMI和T2DM患者提供有价值的补充信息。
