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ABSTRACT: In a precedent study we observed that overall adiposity evaluated with the body mass index (BMI) was correlated with plasma viscosity and red blood cells (RBC) aggregation while abdominal obesity as assessed with the waist to hip ratio (WHR) was correlated with hematocrit. We investigated this issue in 129 women (age 15-65 years, BMI: 15 to 44 kg/m2, WHR: 0.65 to 1.13, fatness: 12-58%) who were divided into fatness groups: 17 underweight women (BMI <18.5), 75 normal weigh (BMI 18.5-24.9), 11 overweight (BMI 25-29.9), and 26 obese (BMI >30) divided according to WHR into 13 lower body and 13 upper body obese women. Whole blood viscosity significantly increases across obesity classes, and is higher in upper body than in lower body obesity (2.84 ± 0.08 vs 3.29 ± 0.09 mPa.s, p < 0.05). The correlations between whole blood viscosity and BMI (r = 0.383 p < 0.01) and WHR (r = 0.364 p < 0.01) are found again. The former is explained by correlations of BMI with plasma viscosity (r = 0.303 p < 0.01) and red cell rigidity (r = 0.356 p < 0.01) and the latter is only explained by a correlation between WHR and hematocrit (r = 0.524 p < 0.01). BMI is also correlated with RBC aggregation parameters. Actually, when total fatness is evaluated with the percentage of fat (%fat) given by bioimpedance analysis (BIA), the picture is slightly different, since %fat is correlated with whole blood viscosity and RBC aggregation parameters but not with hematocrit, plasma viscosity and red cell rigidity. Fat free mass is also correlated with whole blood viscosity (r = 0.227 p < 0.02) due to a correlation with hematocrit (r = 0.483 p < 0.01) but neither RBC rheology nor plasma viscosity. This study shows that fatness by its own is associated with increased red cell aggregation, that abdominal fat increases blood viscosity due to a rise in hematocrit, and that overall body size as assessed with the BMI is associated with increased plasma viscosity and red cell rigidity.
Clinical hemorheology and microcirculation 03/2013; · 3.40 Impact Factor
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ABSTRACT: Body composition and nutrition have been reported to be correlated with blood rheology. However, in sedentary and in physically active individuals these relationships seem to be not exactly similar. This study investigated whether exercise training status influences these relationships. 32 athletes (ATH) (age: 25 ± 0.7 yr; body mass index (BMI): 23.75 ± 0.23 kg/m2) were compared to 21 sedentary subjects (SED) (age: 45.19 ± 2.90; BMI = 33.41 ± 1.33) with nutritional assessment (autoquestionnaire), bioelectrical impedancemetry, viscometry at high shear rate (MT90) and Myrenne aggregometer. Subjects differ according to age, weight and adiposity parameters. Their eating behavior is different: ATH eat a higher percentage of protein (p < 0.005), a lower percentage of lipid (p < 0.05), and a higher total amount of carbohydrate (+31% p < 0.02). Their viscosity factors are similar except plasma viscosity which is higher in SED than ATH (1.51 ± 0.03 vs 1.43 ± 0.02 mPa.s, p < 0.05). In both ATH and SED, abdominal obesity (waist-to-hip ratio or WHR) is associated with impairments in blood rheology, but not exactly the same. In ATH, WHR is associated with an increase in hematocrit (r = 0.647; p = 0.009), plasma viscosity (r = 0.723; p = 0.002), and caloric (and CHO) intake moderately increase RBC rigidity (r = 0.5405; p = 0.0251) and aggregability (r = 0.3366 p = 0.0596). In SED the picture is different, adiposity increases hematocrit (r = 0.460; p = 0.048), abdominal fatness increases blood viscosity independent of hematocrit, and CHO intake is associated with lower RBC aggregability (r = -0.493; p = 0.0319).
Clinical hemorheology and microcirculation 02/2013; · 3.40 Impact Factor
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ABSTRACT: In studies using the intravenous glucose tolerance test with minimal model analysis we reported that low insulin sensitivity (SI) is associated with increased erythrocyte aggregability and plasma viscosity, that appeared to be markers of insulin resistance. Recently, development of modelling has made available a new approach of insulin sensitivity from oral glucose tolerance test data (oral minimal model). We aimed at determining in 111 subjects (51 men, 62 women, age 11-77 yr), insulin sensitivity with this approach together with blood viscosity parameters. With this approach the Myrenne indexes of red cell aggregation were negatively correlated to SI (M; r = -0.456; p = 0.0007; M1; r = -0.397; p = 0.004) while plasma viscosity was not. Correlations with fasting insulin levels (Ib) were weaker (M; r = 0.2711; p = 0.05; M1; r = 0.373; p = 0.007). Accordingly, a stepwise regression analysis selects M as the best correlate of SI and M1 as the best correlate of Ib. With this approach plasma viscosity does not exhibit any clear relationship with SI. This study supports the concept that RBC hyperaggregability is the prominent hemorheologic symptom of insulin resistance.
Clinical hemorheology and microcirculation 01/2012; 51(1):29-34. · 3.40 Impact Factor
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ABSTRACT: Insulin resistance is associated with a mild hyperviscosity syndrome, which is more closely related to insulin resistance than to the clinical scoring of the metabolic syndrome. In studies using the intravenous glucose tolerance test with minimal model analysis we reported that low insulin sensitivity (SI) is associated with increased erythrocyte aggregability (EA). Actually, this issue is confusing because insulin resistance is often associated with compensatory hyperinsulinemia (insulin being a hormone with reported hemorheologic effects) and that a decline in insulin secretion has marked metabolic effects that modify blood rheology. From the intravenous glucose tolerance test (IVGTT) the minimal model allows the calculation of SI, insulin response, and an overall glucose tolerance parameter termed "disposition index" (DI) that measures whether insulin response is adequate or not for the level of insulin sensitivity. In this study we assessed SI, insulin response, and DI during an IVGTT in 335 subjects of both genders (age 8-77 yr; BMI 14-67 kg/m2). SI was only correlated (negatively) with EA (Myrenne M r = -0.285; p = 0.0001; M1 r = -0.240 p = 0.003). Fasting insulin was also correlated (positively) with EA (Myrenne M r = 0.233, 0.00880; M1 r = 0.320 p = 0.0003; SEFAM TA r = -0.342 p = 0.04; SEFAM S60 r = 0.419 p = 0.01) and SEFAM RBC disaggregation thresholds (γS = r = 0.372 p = 0.025; γD = r = 0.504 p = 0.002). Fasting DI (SI × fasting insulin) is negatively correlated to M (r = -0.274; p = 0.002) and M1 (r = -0.225; p = 0.01) but also positively to whole blood viscosity (r = 0.168; p = 0.01) and hematocrit (r = 0.142; p = 0.05). Stimulatory DI (SI × insulin peak) fails to be correlated with any parameter of EA but is negatively correlated to whole blood viscosity (r = -0.150; p = 0.02) and plasma viscosity (r = -0.163; p = 0.01). This study confirms that red cell aggregability is associated with insulin resistance and hyperinsulinemia, but plasma viscosity seems to be more related to overall glucose tolerance than to either SI or insulinemia.
Clinical hemorheology and microcirculation 01/2012; 51(1):21-7. · 3.40 Impact Factor
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ABSTRACT: While recent studies suggested that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio (WHR) in addition to body index mass (BMI) in assessing the risk of death, this issue remains cintroversial since most authors conclude that BMI explains almost all the obesity-related risk of diabetes and conary heart disease (CHD). We investigated the separate effects of BMI and WHR on blood rheology in 430 patients attending to a metabolic check-up and exhibiting all the spectrum of age (11-77 yr) and BMI (15-50 kg/m2). BMI and WHR are correlated to each other (r = 0.269; p = 0.009) and are both predictors of blood viscosity (BMI: r = 0.15516; p = 0.004; WHR: r = 0.3638; p = 0.03). However while looking at determinants of viscosity these correlations had not the same meaning. For BMI it was explained by its correlation with plasma viscosity (r = 0.17718; p = 0.00105) and red blood cells (RBC) aggregation (all Myrenne and SEFAM indices with r ranging between 0.226 and 0.430) while these parameters were not correlated to WHR. By contrast WHR was strongly correlated with hematocrit (r = 0.524; p = 0.0003) which was not correlated with BMI. A forward stepwise regression selected WRH as a better predictor of blood viscosity, excluding BMI. Thus both BMI and WHR are associated with increased blood viscosity but these correlations reflect separate mechanisms. These data suggest that both overall adiposity and abdominal adiposity induce hyper viscosity, consistent with epidemiological studies linking the risk of CHD to abdominal adiposity and BMI.
Clinical hemorheology and microcirculation 01/2011; 48(4):257-63. · 3.40 Impact Factor
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ABSTRACT: The aim of this study was to assess on a large series of soccer players our previous reports on blood rheology and exercise performance. In 99 soccer players (Age 24,17 ± 0,42 yr; weight 75,87 ± 0,89 kg; VO2max 46,86 ± 0,95 mL/min/kg) an exercise test was performed for measuring maximal aerobic capacity and we measured blood viscosity at high shear rate (MT90 viscometer) and RBC aggregation (Myrenne MK1). The French questionnaire developped by the consensus group on overtraining of the French Society of Sports Medicine (SFMS) was also employed. The only hemorheologic statistical determinant of VO2max was hematocrit (Hct r = -0.2439; p = 0.0303). The lactate threshold 2 mmol/l was negatively correlated to M1 (r = -0.43224; p = 0.00847). There was a borderline correlation between the overtraining score at the questionnaire of the SFMS and plasma viscosity (r = 0.3080; p = 0.0532). Therefore, our study confirms that aerobic capacity in this sport is negatively correlated to hematocrit, that RBC aggregation is positively associated with blood lactate accumulation in blood during exercise, and that plasma viscosity is one of the parameters that increase when the athlete is on the edge of the overtraining syndrome. These data are consistent with previous reports about soccer players but caution is needed to extrapolate to other sports.
Clinical hemorheology and microcirculation 01/2011; 49(1-4):225-30. · 3.40 Impact Factor
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ABSTRACT: Aerobic capacity and performance are associated with increased blood fluidity, while sedentarity leads to decreased exercise performance, and blood hyperviscosity. We aimed at investigating the relationships among body composition, blood rheology and exercise performance in this situation. In 46 sedentary subjects (53.09 ± 1.79 yr old; BMI = 32,35 ± 0,80) attending our unit for an exercise prescription we performed an exercise test to assess aerobic capacity, together with blood lipid profile and blood viscosity (MT 90 viscometer, Myrenne erythroaggregometer). The maximal aerobic capacity VO2max was not correlated to blood rheology but its changes were negatively correlated to those of plasma viscosity (r = -0.679) and pre-training VO2max values were negatively correlated to the BMI (r = -0.45873; p = 0.00430) and fatness (waist circumference r = -0.53476; p = 0.00406). Hemorheological parameters were as expected correlated to blood lipids. The main determinant of the RBC rigidity index Tk was HDL-cholesterol (r = -0.70026; p = 0.00121). The main determinant of M1 is HDL-cholesterol (r = -0.5157; p = 0.0238). RBC aggregability "M" is negatively correlated to total cholesterol (r = -0.758932; p = 0.000105); HDL-cholesterol (r = -0.62232; p = 0.00444); LDL-cholesterol (r = -0.64486; p = 0.00386). Whole blood viscosity is correlated to triglycerides (r = 0.8569; p = 0.00000140) and negatively correlated to HDL-cholesterol (r = -0.5622; p = 0.0122). Waist circumference (an index of abdominal fatness) is correlated to blood viscosity (r = 0.597; p = 0.00888). The waist to hip ratio is correlated to Hct (r = 0.70075 p = 0.00120) and to blood viscosity (r = 0.8124334; p = 0.0000420). Fat-free mass is correlated to blood viscosity (r = 0.66528; p = 0.00137) and hematocrit (r = 0.64350; p = 0.00220). Hip circumference is negatively correlated to plasma viscosity (r = -0.5007; p = 0.0290). Therefore, this study confirms that hemorheological parameters are influenced by blood lipids, that changes in plasma viscosity are correlated to those of aerobic capacity, and that abdominal fat mass is associated with a worsening of blood rheology and of exercise performance. By contrast, gluteal fat (a factor associated with favorable lipid profile and high insulin sensitivity) is associated with a decrease in plasma viscosity, and fat-free mass is associated with higher blood viscosity and hematocrit, consistent with recent literature linking its size in abdominal obesity with a deleterious metabolic profile.
Clinical hemorheology and microcirculation 01/2011; 49(1-4):215-23. · 3.40 Impact Factor
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ABSTRACT: Athletes involved in rugby are characterized by a very specific pattern of body composition with an unusually important muscle mass. In a preceding study about rugbymen we evidenced that they exhibit a correlation between red blood cell aggregability and the amount of body fat although it remains within a normal range, and that red cell rigidity was correlated to isometric adductor strength. We had the opportunity of studying the relationships among exercise performance, body composition and hemorheology in 19 female rugby players (age 19-26, mean: 24.47 ± 0.67 yr) practising 4 - 10 hr/wk (mean 7.15 ± 0.3) since 1-12 yr (mean 4,05 ± 0,694). VO2max was not related by its own to blood rheology, either hematocrit (r = -0.0717 p = 0.7706) or plasma viscosity (r = 0.0144; p = 0.9533), but other markers of performance exhivited a correlation with red cell rheology. Relationships between fitness and body composition were evidenced. Isometric handgrip strength was negatively correlated to red blood cell aggregability (Myrenne M, r = -0.57839; p = 0.00948 M1 r = -0.58910; p = 0.00795). Adductor isometric strength was negatively correlated to red blood cell aggregability Myrenne M (r = -0.5033; p = 0.0280) but not to M1 (r = -0.4227; p = 0.0714). Fat mass is a major determinant of the maximal oxygen consumption VO2max either measured by a field test (r = -0.766; p = 0.00013) or exercise test (r = -0.575; p = 0.00994) and was also negatively correlated to both handgrip (r = -0.4918; p = 0.0325) and RBC aggregability M (r = -0.57839; p = 0.00948 and M1 r = -0.5891; p = 0.00795). Independently of fat mass, FFM appears to be a determinant of blood viscosity (r = 0.4622; p = 0.0463) due to its correlation with RBC rigidity (r = 0.4781; p = 0.0384). Thus, trained young women exercising 4-10 hr/wk and thus exhibiting a low percentage of body fat exhibit clear relationships between body composition and hemorheology, but fat mass being low, the parameter correlated with blood rheology is in this case fat-free mass, consistent with recent findings indicating that high fat mass in women is sometimes correlated with parameters of the metabolic syndrome such as insulin resistance or inflammation. In addition, parameters quantifying fatness even within such a physiological range are in this sample negatively related with exercise performance.
Clinical hemorheology and microcirculation 01/2011; 49(1-4):207-14. · 3.40 Impact Factor
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ABSTRACT: Regular exercise has been reported to improve blood rheology, but all the studies investigating this issue included a reduced number of subjects, and thus it was logic to perform a meta-analysis of them in order to better characterize this physiological effect. Research was handed on Medline from 1950 to 2010. Studies were selected if they were in English and if they had one or several of these following outcomes: lactate, blood viscosity, RBC rigidity, hematocrit (%), RBC aggregation, fibrinogen and plasma viscosity. They were also kept if they included exercise in their protocol. Results were computed with the fixed effect model and the weighting method was the inverse variance. 11 studies with 175 people were found and included in this meta-analysis. None of these studies had the whole mentioned outcomes. The meta-analysis shows significant effects on on RBC aggregation (-0.59 CI 95% [-0.72; -0.46]), whole blood viscosity (-0.30 [-0.31; -0.28] p < 0.001) and hematocrit (-0.296%; CI 95% [-0.57; -0.01]). Aggregation, hematocrit and viscosity data showed significant heterogeneity, aggregation I(2) = 94.95%, hematocrit I(2) = 96.46%, viscosity I(2) = 99.25%. RBC aggregation (0.53 CI 95% [0.40; 0.66]). Three studies could be included for an intervention versus control analysis which shows significant effects on hematocrit (-1.06% CI 95% [-1.43; -0.68]) but not on aggregation, with again a significant heterogeneity (hematocrit I(2) = 96.46%). These results confirm that regular exercise decreases hematocrit and RBC aggregation, but the heterogeneity which is evidenced should be pointed out. This heterogeneity will require a new computation taking into account a "random effect" by using a pooling method. In addition, this heterogeneity leads to conclude that more studies are needed to further analyze these effects which are described by a low number of articles, which could explain some of the non-significant results.
Clinical hemorheology and microcirculation 01/2011; 49(1-4):199-205. · 3.40 Impact Factor
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ABSTRACT: It is well known that body composition influences blood rheology (higher blood viscosity and RBC aggregation in obese individuals). On the other hand, blood rheology is related to exercise performance (the fitter the athlete the more fluid the blood). The 'paradox of hematocrit' is that most of the time trained athletes have a lower hematocrit while doping aims at increasing it, a situation which seems to challenge physiology and can be explained by the fact that systemic hematocrit may have poor physiological relevance at the microcirculatory level in exercising muscles. However, recent studies dealing with the marked differences among hemorheologic profiles observed in selected sports lead to the concept that the relationships between hemorheology and performance on one hand and body composition and hemorheology on the other hand are more complex and somewhat different according to the variety of exercise and the physiological and/or pathophysiological background. Increased fat mass, but also fat free mass independently of fat mass, are both correlated to impairments of blood fluidity, consistent with the emerging concept that beside increases in fat mass, increases in fat free mass may also be related to metabolic and circulatory disturbances.
Clinical hemorheology and microcirculation 01/2011; 49(1-4):183-97. · 3.40 Impact Factor
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ABSTRACT: We investigated the measurement of insulin sensitivity (S (I)) with a standardized hyperglucidic breakfast (SHB) compared to minimal model analysis of an intravenous glucose tolerance test (S (I)-IVGTT) in 17 patients clinically referred as type 2 diabetics, not yet treated by insulin, and representing a wide range of body mass index and S (I). To classify the patients, ten meal-tolerance test-based calculations of S (I) (MTT-S (I)) were compared to S (I)-IVGTT, and their reference values and distribution were measured on a separate sample of 200 control SHBs and 209 control IVGTTs. Eight MTT-S(I) indices exhibit significant correlations with S (I)-IVGTT: Mari's OGIS index, BIGTT-SI|(0-30-120), BIGTT-SI|(0-60-120,) 1/G (b) I (m), Caumo's oral minimal model (OMM), Sluiter's index "A" = 10(4)/(I (p)·G (p)), Matsuda's composite index given by the formula ISIcomp = 10(4)/(I (b) G (b) I (m) G (m))(0.5), S (I) = 1/I (b) G (b) I (m) G (m) with r (2) ranging between 0,53 and 0,28. S (I)-IVGTT and S (I)-MTT exhibited in the lower range a very different (non-normal) pattern of distribution and thus the cutoff value for defining insulin resistance varied among indices. With such cutoffs, S (I)-MTT < 6.3 min(-1)/(μU/ml) 10(-4) with Caumo's OMM was the best predictor of insulin resistance defined as S (I)-IVGTT < 2 min(-1)/(μU/ml) 10(-4). Other indices, including OGIS and BIGTT, resulted in more misclassifications of patients. HOMA-IR and QUICKI were poor predictors. The formula [Formula: see text] satisfactorily predicts IVGTT-derived glucose effectiveness in type 2 diabetics. Thus, SHB appears suitable for the measurement of S (I) and S (G) in type 2 diabetics, and the OMM seems to provide the most accurate SHB-derived index in this population.
Acta Diabetologica 10/2010; · 2.78 Impact Factor
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Philippe Connes,
Suhr Frank,
Cyril Martin,
Sehyun Shin,
Emeline Aufradet,
Sub Sunoo,
Brixius Klara, Eric Raynaud de Mauverger,
Marc Romana,
Laurent Messonnier,
Joonku Kang,
Emmanuelle Varlet-Marie,
Leonard Feasson,
Marie-Dominique Hardy-Dessources,
Bloch Wilhelm,
Jean-Frederic Brun
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ABSTRACT: The present article summarizes recent data presented at the Exercise and Hemorheology symposium during the 15th Conference of the European Society for Clinical Hemorheology and Microcirculation (June 28-July 1, Pontresina, Switzerland, 2009). The review starts with several unresolved paradoxes in exercise hemorheology. Then, we focus on the potential hemorheological and immunological mechanisms involved in the adverse events sometimes reported in exercising sickle cell trait carriers, and the role of habitual physical activity. In a fourth part, new results on the effects of acute hypoxia on blood rheology are presented. Finally, we will discuss recent experimental evidences on the role of exercise on the regulation of nitric oxide synthesizing mechanisms in red blood cell.
Clinical hemorheology and microcirculation 01/2010; 45(2-4):131-41. · 3.40 Impact Factor
