Abstract
Hemorheological disorders in structural and functional parameters of erythrocytes are involved in the pathological process in type 2 diabetes mellitus (DM). Aim: to investigate the feasibility of differential diagnosis of the degrees of rheological disturbances in patients with type 2 DM by dielectrophoresis of erythrocytes. Methods: 62 subjects (58.7 ± 1.6 years) with type 2 DM diagnosed according to the criteria of the ADA were subdivided into two groups: medium (n = 47) and high (n = 15) risk of microcirculatory disturbances (EASD, 2013). Electric and viscoelastic parameters of erythrocytes were determined by dielectrophoresis using an electric optical system of cell detection. Results: the progression of rheological disturbances in the patients with type 2 DM was accompanied by significant decreases in deformation amplitude; dipole moment; polarizability; and membrane capacity; and increases in conductivity, viscosity, rigidity, hemolysis, and formation of aggregates (p < 0.05). Combined use of the parameters increased sensitivity (97.8%) and specificity (86.7%) for diagnosis of rheological disturbances in type 2 DM. Conclusion: the proposed experimental approach possesses low invasiveness, high productivity, shorter duration, vividness of the results. The method allows to evaluate not only local (renal and ocular) but also systemic status of microcirculation using more than 20 parameters of erythrocytes.
Highlights
Among patients with diabetes mellitus (DM), early disability and mortality, which are mostly caused by diabetic angiopathies, are the most important socioclinical problem of modern diabetology [1]
Hemorheological disorders in structural and functional parameters of erythrocytes are involved in the pathological process in type 2 diabetes mellitus (DM)
On the basis of the above-mentioned criteria, our patients with DM were distributed into two groups: a medium risk of damage to small vessels, i.e., medium severity of rheological and microcirculatory disturbances (Group 2; n = 47), and high risk of microcirculatory disturbances (Group 3; n = 15)
Summary
Among patients with diabetes mellitus (DM), early disability and mortality, which are mostly caused by diabetic angiopathies, are the most important socioclinical problem of modern diabetology [1]. Clinicians utilize several methods: slit-lamp examination of the conjunctiva, fundoscopy, retinal fluorescent angiography, quantitative perimetry, autocampigraphy, and examination of darkness adaptation These methods allow visual evaluation of the state of retinal vessels and extrapolation of the obtained results to the vascular system as a whole. The shortcomings of direct ophthalmoscopy are a small examined area, the absence of stereoscopy, close contact with a patient, and the inability to examine the extreme periphery of the fundus In clinical practice, this approach is convenient as a screening method of medical examination. Contact binocular ophthalmoscopy by means of a slit lamp and contact lenses is the golden standard of diagnosis of fundus pathologies This method has limitations related to inflammatory processes on the eye surface, well-pronounced opacification or degenerative alterations of the cornea, and health state of the patient (e.g., convulsive disorder or epilepsy) [2]. A microalbuminuria test, urinary sediment analysis, measurement of glomerular filtration using endogenous creatinine, and other assays that only indirectly evaluate the presence of microvascular changes in kidneys during DM, are more informative at later stages, necessitate a set of expensive equipment, are costly, and require specially trained personnel [3]
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