Hemorheology in Insulin Resistance
Pp. 99-106 (8)
Jean-Frederic Brun, Emmanuelle Varlet-Marie, Ikram Aloulou, Mathieu Sardinoux, Eric Raynaud de Mauverger and Jacques Mercier
The insulin resistance syndrome is associated with hemorheologic
abnormalities whose understanding is complex, since rheological properties
of plasma and blood cells are to a large extent determined by the surrounding
milieu: physicochemical factors, metabolism and hormones. It is thus
difficult to delineate the specific role of adiposity, endothelial dysfunction,
and the hormonal disturbance by its own in this complex picture.
Nevertheless, low insulin sensitivity which is associated with both increased
body fat and increased circulating lipids, together with impaired fibrinolysis,
is characterized by a mild hyperviscosity syndrome. Those rheological
alterations are more closely related to insulin resistance than to the clinical
scoring of the metabolic syndrome. Low insulin sensitivity is associated with
increased erythrocyte aggregability. When low insulin sensitivity is
associated with hyperinsulinemia there is an increase in plasma viscosity.
Among those factors, plasma viscosity appears, in multivariate analysis, to be
"independently" related to insulin resistance. Moreover, plasma
hyperviscosity is corrected by insulin-sensitizing procedures (such as
exercise training) and is thus to some extent a marker of this disease.
INSERM ERI 25 Muscle et Pathologies, Service Central de Physiologie Clinique, Centre 'Exploration et de Réadaptation des Anomalies du Métabolisme Musculaire (CERAMM), CHU Lapeyronie, 34295 Montpellier cédex 5, France.