ИСТИНА

The aim was to Investigate the correlations between parameters of blood rheology and skin microcirculation in patients with type 1 and 2 diabetes mellitus (t1DM & t2DM). The study was carried out with blood of 9 patients suffering t1DM (4 women and 5 men, 58,5 ± 10,1 years old) and 8 patients suffering t2DM (5 women and 3 men, 26,6 ± 2,9 years old). The disease duration for all patients was more than 5 years. The glycated hemoglobin (HbA1c) level was 8,55 ± 1,53% in t1DM group and 9,21 ± 2,14% in t2DM. For measurements of erythrocyte aggregation the aggregometer MA-1 (Myrenne, Germany) was used. The intensities of light transmitted through the blood sample in the cone-plate system for 5 seconds and 10 seconds at stasis (5M, 10M) and at low shear flow (5M1, 10M1) were registered. The aggregometer-deformometer «LADE» (ReoMedLab, Russia) was used for assessing the kinetics of spontaneous aggregation and shear induced disaggregation of the erythrocytes. The kinetics were obtained by the registration of time dependence of the intensity of the light backscattered from blood samples with 40% hematocrit. Computer analysis of the kinetics yields the characteristic time of linear (T1) and three-dimensional (T2) aggregates formation, as well as hydrodynamic strength of the aggregates (Beta). Skin microcirculation (perfusion) was measured using the LAKK-02 complex (LASMA, Russia), that measures the microcirculation index in perfusion units. The sensor device was applied to the dorsum of the right foot. Microcirculation measurements were performed using the combined heat-postural test (changing in the body position during the local heating). Correlations were analyzed with Spearman's rank correlation test. We revealed strong positive and negative correlations between baseline perfusion and indicators 5M, 10M (R> 0,7; p <0,05), 10M/5M ratio, T1 (R <-0,7; p <0,05) in t1DM group. Strongly expressed negative correlation between perfusion level at heating with 10M/5M ratio and Beta index (R<-0,7; p<0,05) was observed. The level of perfusion under combination of temperature and postural impacts (relative to the perfusion at rest) was correlated with the indicators of 5M, 10M (R <-0,7; p <0,05), T1 (R = 0,83; p <0,05). Correlations were found between baseline perfusion and 5M1/5M ratio (R=0,71, p <0,05), T2 (R=-0,74; p<0,05), as well as between the level of perfusion under combination of temperature and postural impacts (relative to the perfusion at rest) and 10M1/5M1 ratio (R=0,81, p<0,05) in t2DM group. We observed highly expressed correlations between the parameters of blood rheology and skin microcirculation, which suggest that hemorheology of blood has an impact both on the basic perfusion and on the result of the functional tests (vessels reaction on heating, occlusion). The difference between the correlations for different types of diabetes occurs due to the difference in pathogenesis of these diseases and age-related alterations. The work was financially supported by the Russian Scientific Foundation, grant № 14-15- 00602.