RED BLOOD CELL (RBC) MEMBRANE DEFORMABILITY AND WHOLE BLOOD VISCOSITY IN INFANTS OF DIABETIC MOTHERS (IDM)

Abstract

Impaired RBC deformability decreases RBC survival. In IDM, this may lead to obstruction in microvasculature resulting in NEC, other vascular complications, and hyperbilirubinemia. The present study was designed to evaluate RBC deformability using Ektacytometer (Blood, 61:889, 1983), whole blood viscosity, hematocrit (Hct) and clinical status in IDMs (N=7). Controls (N=7) were normal infants matched for race, sex, and gestation.

Two IDMs were LGA and 5 AGA, with GA 37-39 wks. IDMs had significant ↓ in T½ of deformability index (DI), greater RBC surface area and ↑ in RBC Water content compared to controls (p<0.05). IDMs born to insulin-dependent mothers had greater ↓ in RBC DI compared to class A diabetics. No correlation was found in IDMs between DI, viscosity, Hct, and HBA₁ C levels. There was no significant difference in viscosity and Hct between IDMs and controls. One infant of class C mother had marked ↓ in RBC deformability parameters with Hct of 66%, and normal viscosity of 12.1 cps at a shear rate of 11.5 sec⁻¹. He developed NEC and hyperbilirubinemia (peak bilirubin=20.6 mg/dl).

Our study suggests that RBCs of IDMs are less deformable, without a change in whole blood viscosity compared to normal infants. This may result in significant clinical manifestations. The biochemical basis for this has been previously shown by us to be alteration in the lipid bilayer, demonstrated by ↑ cholesterol and cross-linking of lipids in the RBCs of IDMs.

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