Total VLDL Concentration may increase Blood Viscosity and microvascular complications in diabetics: Study

Several studies have shown associations between very high triglyceride concentrations and BV. However, the contribution of mild to moderate hypertriglyceridemia (HTG) and BV is less certain. Therefore, Dr Robert S. Rosenson and his team conducted a study to assess the associations between lipoprotein particle size and concentration and BV in patients with T2DM and mild to moderate HTG.

In a cross-sectional study, the researchers included 70 adults (45% female) with lower extremity arterial disease and T2DM from the Hema-kinesis trial. BV levels at 5 s
1 are reported as low-shear viscosity, and BV measurements at 300 s
1 are reported as high-shear viscosity. They measured the lipoproteins s [VLDL, LDL and HDL] and whole blood cells and quantified using the amplitudes of their spectroscopically distinct lipid methyl group NMR signals.

Key findings of the study:

• Upon analysis, the researchers found that the triglycerides were not associated with BV; however, concentrations of total VLDL were associated with BV at low-shear and high-shear rates.
• Upon multivariate models that included fibrinogen and serum globulins, they found that the total VLDL concentration was associated with low-shear (R2 = 0.141) and high-shear viscosity (R2 = 0.135).
• They noted that these associations remained significant after adjustment for red cell count at low-shear (R2 = 0.143) and tended towards significance at high-shear (R2 = 0.136).
• However, they noted that total VLDL concentrations were not significantly associated with BV after adjustment for hematocrit.

The authors concluded, "total VLDL concentrations is associated with high BV even in the absence of chylomicrons and at lower triglyceride levels considered in the aetiology of microcirculatory flow abnormalities in patients with diabetes. Measurement of VLDL concentration may impart more insight into the variable associations between triglyceride-mediated microcirculatory abnormalities in patients with diabetes."

For further information:

DOI: https://doi.org/10.1016/j.diabres.2021.109180