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

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 (t 1/2 ), threshold shear rate (␥ thr ), the fast (T fast ) and the slow (T slow ) 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, ␥ thr , T slow correlated positively with BMI, WHR, total cholesterol level and low-density lipoproteins. Negative correlation presented t 1/2 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.

Significantly increased low shear rate viscosity, blood elastic modulus, and RBC aggregation in adults following cardiac surgery

“…Fib and CRP are protein factors commonly sensitive to RBC aggregation, as they both correlate with infection, trauma, and inflammation 48 . The Fib and HCT levels in the Control were approximately 258 ± 14 mg/dl and 42 ± 3% respectively; these results are similar to the values of 245 ± 30 mg/dl and 41 ± 4% reported previously 49 . Fib was generally higher for the patients than the Control.…”

The effects of obesity on CD47 expression in erythrocytes

“…CD47 expression on the membrane surface of RBCs was assessed using a monoclonal antibody against CD47, conjugated to allophycocyanin fluorochrome (eBioscience, San Diego, CA). For this purpose, an aliquot of washed and diluted peripheral blood containing 10 6 RBCs was incubated with CD47 antibody for 15 min in the dark. Subsequently, the sample was washed once with CellWash solution, resuspended in 250 mL of FACS Flow solution (Becton Dickinson) and 100,000 cells were acquired with the FACS Canto II flow cytometer (Becton Dickinson).…”

“…The ability of RBCs to aggregate plays a prominent role in the low shear-dependent behavior of blood viscosity and contributes to blood flow (1,2). Obesityrelated increases in erythrocyte aggregation have been documented in several studies (3)(4)(5)(6). Most studies show that the obese population presents plasma-dependent RBC hyperaggregability (7).…”

Protein kinase R and the metabolic syndrome

“…It has been reported earlier that prooxidants and adipocytokines generated in metabolic syndrome alter erythrocyte morphology, increase whole blood viscosity and decrease erythrocyte deformability. The combination of oxidative stress, inflammation and hematological factors have a detrimental effect in metabolic syndrome due to the disturbance in microcirculation [19,20,21].…”