Increased Red Blood Cells in Patients with Metabolic Syndrome

Abstract

We read with great interest the recently published study by Kim et al. [1] on the relationship of red blood cell counts (RBCCs) to metabolic syndrome (MS), and its sex differences. They indicate that RBCCs are not associated with MS components in men and women. Until now, a few studies have reported a positive association of RBCCs, hemoglobin (Hb) and hematocrit with MS [2] or insulin resistance syndrome [3,4], with no mention of sex differences. These reports have provoked debate on red blood cell (RBC)-related variables as potential markers related to MS.Kim et al.[1] speculate that prior study populations may incompletely exclude patients with hematological problems, and propose reevaluation in only healthy subjects without Hb-related disorders. Thus, we investigated the associations of RBCCs and Hb with MS in a subjectively healthy Japanese population (n = 469, age = 49.4 ± 9.3 [SD], [range = 30-83] years). Subjects with Hb values from 12 to 16 g/dl and white blood cell counts (WBCCs) from 3,500 to 11,000/mm 3 were enrolled. None of the subjects were on medication, nor had apparent cardiovascular, pulmonary, hepatic, renal, malignant, infectious or hematological disorders. MS was defined by the presence of ≥3 components according to NCEP ATP III criteria with minor modifications such as obesity based on BMI values of ≥25, similar to the Kim study [1]. RBCCs and Hb were measured with an autoanalyzer. All analyses were performed using the general linear model, two-way ANOVA and multiple regression analysis, adjusted for age, sex and smoking status (non-, ex-and current smoking). P<0.05 was considered significant.The respective RBCCs and Hb levels were significantly higher in the presence of MS for each sex (p for trend<0.001), with significantly higher levels in men than women (p for trend<0 . 14.9 ± 0.73 g/dL without MS, 13.8 ± 1.11 in women with MS vs. 13.3 ± 0.77 without MS. The respective variables had a significantly increasing trend according to increases in MS components in each sex, with significantly higher levels in men than women (Table 1) Our study supports the hypothesis that RBC-related variables, RBCCs in particular, are indicators related to MS and its components (whereas the variable levels differed between sexes), contrary to the Kim study for Korean people [1]. This discrepancy may be explained by differences in study populations. In addition to ethnic differences, our study focused more on subjects without Hb-related disorders compared to those of the Kim study. Although the detailed mechanisms remain unclear on the associations of RBC with MS, insulinrelated effects on RBC have been suggested [1]. Ethnic background, including genetic and environmental factors, may also affect the associations of RBC with MS, as shown in the differences in some RBC-related hematological variable levels [5] and in the prevalence of MS or its related-cardiovascular diseases [6]. Regarding other hematological variables, positive associations between WBCCs and MS have been reported [1,7,8], while associations ...

Associations between red blood cell count and metabolic dysfunction-associated fatty liver disease(MAFLD)

“…Chinese population [21]. Kotani confirmed that red blood cell count is an indicator related to Mets and its components, contrary to Kim's study on Koreans with no relationship discovered between them [22,23]. In this study, RBC was significantly associated with MAFLD in males, with no such trendin females.…”

“…Using a longitudinal cohort design, Zhong et al discovered that RBC is not only connected with the incidence of NAFLD but also the severity of incident NAFLD development in Chinese population [ 21 ]. Kotani confirmed that red blood cell count is an indicator related to Mets and its components, contrary to Kim’s study on Koreans with no relationship discovered between them [ 22 , 23 ]. In this study, RBC was significantly associated with MAFLD in males, with no such trendin females.…”

Application of a Machine Learning Technology in the Definition of Metabolically Healthy and Unhealthy Status: A Retrospective Study of 2567 Subjects Suffering from Obesity with or without Metabolic Syndrome

“…These results are along the line of already published data reporting that subjects affected by MS exhibit a higher count of RBCs compared to metabolically healthy subjects. It has been reported that, despite the presence of chronic inflammation which has suppressive erythropoietic effects, erythropoiesis correlates with central obesity and insulin resistance [54] and that RBC count is, even though still within normal range, significantly higher in the presence of MS for each sex [55].…”