[Level of platelet malonaldehyde in diabetics].
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Biomedical subjects
Publications and source records attributed to J P Pointel.
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Plasma beta-TG was measured radioimmunoassay on 23 controls and 84 diabetics. The diabetic patients were divided in three groups: I. Patients without complications, insulin-dependants or not. II. Patients with retinopathy, without severe complications. III. Patients with retinopathy and distal arteritis. beta-TG level in control group is 23,4 +/- 7,6 ng/ml and is comparable with literature. An important increase of beta-TG average level was observed for the three diabetic groups. The almost equal increase between groups I and II could be explained by a comparable hyperagregability, as previously described in diabetes. There could be an increase of hyperagregability with arteritis appearance, and a increase of beta-TG release. Correlation between these two parameters remains to be demonstrated.
Since the works of Singal and al. and Nerup and al., an increase in B 8, B 15 and B 18 antigens has been found in Insulin Dependent Diabetes. Thomson and al., Rubinstein and al. and the authors of this paper have shown an stronger association with DRw 3 and DRw 4 antigens. We investigated the genetic predisposition to juvenile diabetes in 22 families of 48 cases and 96 members. The study of one affected child in each family showed that DRw 3 was found in 63,63% and DRw 4 in 59,59% (healthy 16,22%)--RR = 9,0 and 7,49. The hypothesis of overdominance proposed by Nerup can be confirmed by our data, when I.D.D.M. share two different alleles (DRw 3 and DRw 4). 3 particular haplotypes with linkage imbalance are therefore observed in our series: B 8-Bf S-DRw 3, B 15-Bf F-DRw 4 and B 8-Bf F 1-DRw 3. Our date show a excessive transmission of the diabetic haplotype by parents who are either diabetics or carriers of the gene.
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An intravenous fat tolerance test (IV FTT) was performed in a group of patients with type IV hyperlipoproteinemia before and after reduction of triglyceride level, the latter is obtained through a diet adapted to the nutritional sensitivity, body weight remaining constant. Before the diet the increase in cholesterol (CT) and triglycerides (TG) was related in both obese and non-obese patients to an increase in very-low-density lipoproteins (VLDL), while other lipoprotein fractions were not affected. In these patients, K2 is significantly lower than in controls whatever the nutritional sensitivity. However, K2 is lower in obese patients than in patients with normal weight, VLDL-CT and VLDL-TG are tremendously reduced by the relevant diet and K2 is constantly and significantly increased, although it does not reach a normal value in obese subjects. There is a highly significant correlation between VLDL-TG levels and K2 in obese and non-obese subjects. Several physiopathological explanations are discussed to account for the variation of K2 according to TG levels. The results obtained support the view that the K2 defect is secondary to the hyperlipoproteinemia.
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The blood viscosity of 15 insulin-dependent, poorly controlled, diabetic subjects was determined by using a microviscosimeter at low shear rates, with cylindrical cuvettes of the Couette type. It was found that the blood viscosity of these diabetics was more elevated than that of control patients (p less than 0.001). In ten diabetics, the return to a strict metabolic control over a period of more than 24 h by means of an artificial pancreas resulted in a significant systematic lowering of blood viscosity. These results suggest that the metabolic control of diabetes influences blood viscosity, and they underline the importance of an artificial pancreas for the dynamic study of the factors affecting blood viscosity during the course of diabetes.
The manifestations of diabetic osteoarthropathy are described. Computerized analysis of the films of the feet of 1501 diabetic patients showed one or more lesions in 55% of patients. Exostosis (36%), vascular calcifications (25%) and osteoporosis (12.2%) are by far the most frequent symptoms. Geodes (3.7%), destructive lesions (3.9%), sclerosis (4%) and articular lesions (5.1%) are second in frequency. Osteolytic lesions and reconstruction showed a high female predominance, whereas sclerosis is predominant in males (61.6--38.4%).
A study of blood viscosity at 3 rates of determination (0.232-0.348 and 1.16 sec-1) in insulin-dependent diabetic subjects controlled by artificial pancreas, shows a reduction in this parameter after 30 hours of feed back control. The relationship between these variations, the mechanical cohesion of the agglutinated red cells, and the deformability of these structures are discussed.
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The comparative study of a control group made up of 340 healthy subjects, a group of 100 unrelated patients, all showing signs of type II hyperlipoproteinemia and a family of 15 members covering three successive generations, brings to light the highly significant increase of the recurrence of HLA Bw17 antigen and the increase in frequency of HLA Bw35 antigen.
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Osteo-articular changes observed in diabetic patients include diabetic osteo-arthropathy, infective osteo-arthritis, and osteo-arthrosis. A systematic review of 1,501 case-sheets demonstrated one or more bone lesions in 55% of the diabetic patients studied. There was a striking absence of the most typical lesions of the foot, probably party due to the fact that there has been an improvement in the treatment of diabetes. Osteolytic and reconstructive lesions were more common in women.
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