J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Original Article

Volume 7, Number 5, October 2017, pages 146-152

Clinical Impact of Hemorheology Assessed Using the Microchannel Array Flow Analyzer on Renal Resistive Index in Patients With Type 2 Diabetes Mellitus

Figure 1. Correlation Between WBPT and RRI. The statistically significant positive correlation between WBPT and RRI (r = 0.48, P < 0.001). WBPT: whole blood passage time; RRI: renal resistive index.

Figure 2. Results of Multiple Logistic Regression Analysis for High RRI. High RRI was defined as an RRI ≥ 0.70. Adjustment factors were age, pulse pressure, skin autofluorescence, urinary albumin excretion, and d-ROMs. *P < 0.01 vs. ≤ 50.0 s, **P < 0.001 vs. ≤ 50.0 s. RRI: renal resistive index; WBPT: whole blood passage time; d-ROMs: derivatives of reactive oxygen metabolites.

**Table 1.** Baseline Clinical Characteristics
Continuous values are mean ± SD. HOMA-IR: homeostasis assessment insulin resistance; LDL: low-density lipoprotein; HDL: high-density lipoprotein; eGFR: estimated glomerular filtration rate; d-ROMs: derivatives of reactive oxygen metabolites; RRI: renal resistive index; WBPT: whole blood passage time; RAS: renin-angiotensin system; DPP: dipeptidyl peptidase.
n (male/female)	302 (121/181)
Age (years)	66 ± 12
Body mass index	23.6 ± 3.8
Current smoker, n (%)	57 (19)
Systolic blood pressure (mm Hg)	143 ± 9
Diastolic blood pressure (mm Hg)	90 ± 12
Pulse pressure (mm Hg)	53 ± 13
Pulse rate (/min)	68 ± 11
White blood cell (/µL)	6,490 ± 1,220
Red blood cell (10⁴/µL)	420 ± 40
Hematocrit (%)	38.0 ± 4.0
Platelet (10⁴/µL)	21.2 ± 6.5
Fasting blood glucose (mg/dL)	134 ± 24
Immunoreactive insulin (µg/mL)	7.3 ± 4.4
HOMA-IR	2.5 ± 1.5
Hemoglobin A1c (%)	7.1 ± 1.3
Skin autofluorescence (AU)	2.6 ± 0.6
Total cholesterol (mg/dL)	213 ± 40
LDL-cholesterol (mg/dL)	135 ± 35
Triglyceride (mg/dL)	129 ± 63
HDL-cholesterol (mg/dL)	52 ± 15
eGFR (mL/min/1.73 m²)	63.5 ± 25.7
Log-urinary albumin (mg/g Cr)	1.52 ± 0.53
d-ROMs test (U Carr)	334 ± 99
WBPT (s)	59.3 ± 16.1
RRI	0.70 ± 0.08
Medication
Sulfonylurea, n (%)	157 (52)
Metformin, n (%)	81 (27)
DPP-4 inhibitor, n (%)	172 (57)
Insulin, n (%)	21 (7)
RAS inhibitor, n (%)	166 (55)
Statin, n (%)	163 (54)

Table 1. Baseline Clinical Characteristics

Continuous values are mean ± SD. HOMA-IR: homeostasis assessment insulin resistance; LDL: low-density lipoprotein; HDL: high-density lipoprotein; eGFR: estimated glomerular filtration rate; d-ROMs: derivatives of reactive oxygen metabolites; RRI: renal resistive index; WBPT: whole blood passage time; RAS: renin-angiotensin system; DPP: dipeptidyl peptidase.

n (male/female)

302 (121/181)

Age (years)

66 ± 12

Body mass index

23.6 ± 3.8

Current smoker, n (%)

57 (19)

Systolic blood pressure (mm Hg)

143 ± 9

Diastolic blood pressure (mm Hg)

90 ± 12

Pulse pressure (mm Hg)

53 ± 13

Pulse rate (/min)

68 ± 11

White blood cell (/µL)

6,490 ± 1,220

Red blood cell (10⁴/µL)

420 ± 40

Hematocrit (%)

38.0 ± 4.0

Platelet (10⁴/µL)

21.2 ± 6.5

Fasting blood glucose (mg/dL)

134 ± 24

Immunoreactive insulin (µg/mL)

7.3 ± 4.4

HOMA-IR

2.5 ± 1.5

Hemoglobin A1c (%)

7.1 ± 1.3

Skin autofluorescence (AU)

2.6 ± 0.6

Total cholesterol (mg/dL)

213 ± 40

LDL-cholesterol (mg/dL)

135 ± 35

Triglyceride (mg/dL)

129 ± 63

HDL-cholesterol (mg/dL)

52 ± 15

eGFR (mL/min/1.73 m²)

63.5 ± 25.7

Log-urinary albumin (mg/g Cr)

1.52 ± 0.53

d-ROMs test (U Carr)

334 ± 99

WBPT (s)

59.3 ± 16.1

RRI

0.70 ± 0.08

Medication

Sulfonylurea, n (%)

157 (52)

Metformin, n (%)

81 (27)

DPP-4 inhibitor, n (%)

172 (57)

Insulin, n (%)

21 (7)

RAS inhibitor, n (%)

166 (55)

Statin, n (%)

163 (54)

**Table 2.** Relationship Between RRI, WBPT and Various Clinical Parameters
	r
r expressed correlation coefficient. HOMA-IR: homeostasis assessment insulin resistance; LDL: low-density lipoprotein; HDL: high-density lipoprotein; d-ROMs: derivatives of reactive oxygen metabolites; eGFR: estimated glomerular filtration rate; DPP: dipeptidyl peptidase; RAS: renin-angiotensin system. P < 0.001, P < 0.01, **P < 0.05.
Sex (Female=0, Male=1)	-0.06	0.07
Age	0.26*	0.06
Body mass index	0.09	0.16**
Current smoker (No=0, Yes=1)	0.12***	0.13***
Systolic blood pressure	0.03	0.04
Diastolic blood pressure	-0.28*	0.05
Pulse pressure	0.36*	0.04
Pulse rate	0.07	0.05
White blood cell	0.06	0.06
Red blood cell	0.10	0.10
Hematocrit	0.11	0.13***
Platelet	0.07	0.07
Fasting blood glucose	0.11	0.10
Immunoreactive insulin	0.05	0.05
HOMA-IR	0.06	0.08
Hemoglobin A1c	0.16**	0.12***
Skin autofluorescence	0.41*	0.41*
Total cholesterol	0.03	0.02
LDL-cholesterol	0.02	0.03
Triglyceride	0.09	0.13***
HDL-cholesterol	-0.08	0.08
eGFR	-0.20*	-0.08
Log-urinary albumin	0.34*	0.45*
d-ROMs test	0.40*	0.41*
Sulfonylurea (no = 0, yes = 1)	0.03	-0.08
Metformin (no = 0, yes = 1)	-0.05	-0.06
DPP-4 inhibitor (no = 0, yes = 1)	-0.04	-0.07
Insulin (no = 0, yes = 1)	0.08	0.09
RAS inhibitor (no = 0, yes = 1)	-0.08	-0.07
Statin (no = 0, yes = 1)	-0.08	-0.09

Table 2. Relationship Between RRI, WBPT and Various Clinical Parameters

RRI

WBPT

r expressed correlation coefficient. HOMA-IR: homeostasis assessment insulin resistance; LDL: low-density lipoprotein; HDL: high-density lipoprotein; d-ROMs: derivatives of reactive oxygen metabolites; eGFR: estimated glomerular filtration rate; DPP: dipeptidyl peptidase; RAS: renin-angiotensin system. *P < 0.001, **P < 0.01, ***P < 0.05.

Sex (Female=0, Male=1)

-0.06

0.07

Age

0.26*

0.06

Body mass index

0.09

0.16**

Current smoker (No=0, Yes=1)

0.12***

0.13***

Systolic blood pressure

0.03

0.04

Diastolic blood pressure

-0.28*

0.05

Pulse pressure

0.36*

0.04

Pulse rate

0.07

0.05

White blood cell

0.06

Red blood cell

0.10

Hematocrit

0.11

0.13***

Platelet

0.07

Fasting blood glucose

0.11

0.10

Immunoreactive insulin

0.05

HOMA-IR

0.06

0.08

Hemoglobin A1c

0.16**

0.12***

Skin autofluorescence

0.41*

Total cholesterol

0.03

0.02

LDL-cholesterol

0.02

0.03

Triglyceride

0.09

0.13***

HDL-cholesterol

-0.08

0.08

eGFR

-0.20*

-0.08

Log-urinary albumin

0.34*

0.45*

d-ROMs test

0.40*

0.41*

Sulfonylurea (no = 0, yes = 1)

0.03

-0.08

Metformin (no = 0, yes = 1)

-0.05

-0.06

DPP-4 inhibitor (no = 0, yes = 1)

-0.04

-0.07

Insulin (no = 0, yes = 1)

0.08

0.09

RAS inhibitor (no = 0, yes = 1)

-0.08

-0.07

Statin (no = 0, yes = 1)

-0.08

-0.09

**Table 3.** Multiple Regression Analysis for RRI
Explanatory factor	β	P value
R² = 0.33. RRI: renal resistive index; WBPT: whole blood passage time; d-ROMs: derivatives of reactive oxygen metabolites; eGFR: estimated glomerular filtration rate; β: standardized regression coefficient; R²: coefficient of determination.
WBPT	0.37	< 0.001
Pulse pressure	0.24	< 0.001
Log-urinary albumin	0.22	< 0.001
Skin autofluorescence	0.21	< 0.001
d-ROMs test	0.15	< 0.01
Age	0.12	< 0.05
eGFR	-0.09	0.061

Table 3. Multiple Regression Analysis for RRI

Explanatory factor

P value

R² = 0.33. RRI: renal resistive index; WBPT: whole blood passage time; d-ROMs: derivatives of reactive oxygen metabolites; eGFR: estimated glomerular filtration rate; β: standardized regression coefficient; R²: coefficient of determination.

WBPT

0.37

< 0.001

Pulse pressure

0.24

< 0.001

Log-urinary albumin

0.22

< 0.001

Skin autofluorescence

0.21

< 0.001

d-ROMs test

0.15

< 0.01

Age

0.12

< 0.05

eGFR

-0.09

0.061