Clinical Impact of Hemorheology Assessed Using the Microchannel Array Flow Analyzer on Renal Resistive Index in Patients With Type 2 Diabetes Mellitus

Abstract

Background: The renal resistive index (RRI) assessed using ultrasonography is reportedly associated with not only kidney function but also cardiovascular disease incidence. In contrast, hemorheology assessed using the microchannel array flow analyzer (MC-FAN) has demonstrated the significance of cardiovascular risk factors in recent clinical studies. This cross-sectional study aimed to clarify the clinical impact of hemorheology assessed using MC-FAN on RRI in patients with type 2 diabetes mellitus from the perspective of primary prevention of cardiovascular events. Methods: In total, 302 outpatients undergoing treatment for type 2 diabetes mellitus (121 males and 181 females; mean age ± standard deviation, 66 ± 12 years) with no history of cardiovascular diseases were enrolled. The whole blood passage time (WBPT) was assessed using MC-FAN as a marker of hemorheology, and the relationship between RRI and various clinical parameters including WBPT was examined. Results: A significant positive correlation was observed between WBPT and RRI (correlation coefficient = 0.48; P < 0.001). Furthermore, the multiple regression analysis demonstrated that WBPT was selected as an independent variable for RRI as a subordinate factor (? = 0.37; P < 0.001). Patients with high WBPT (? 70 s) and median WBPT (50.2 - 69.6 s) had a significantly higher risk (odds ratio (OR): 7.9; 95% confidence interval (CI): 2.4 - 19.6; P < 0.01 and OR: 2.1; 95% CI: 1.1 - 7.8; P < 0.05, respectively) of having a high RRI (? 0.70) than those with low WBPT (? 50.0 s). Conclusions: The results of this study indicate that hemorheology assessed using MC-FAN is an important determining factor for RRI in patients with type 2 diabetes mellitus. Furthermore, we suggest that an increase in RRI can be prevented by maintaining WBPT ? 50.0 s. Further investigation of a large number of prospective studies, including intervention therapies, will be required to confirm the results of this study. J Endocrinol Metab. 2017;7(5):146-152 doi: https://doi.org/10.14740/jem448w