Reference intervals of complete blood count constituents are highly correlated to waist circumference: Should obese patients have their own “normal values?”

Abstract

Body mass index (BMI), the prevalent indicator of obesity, is not easily grasped by patients nor physicians. Waist circumference (WC) is correlated to obesity, is better understood and has a stronger relationship to the metabolic syndrome. We compiled WC, complete blood count (CBC) parameters as well as other pertinent data of 6766 25-55-year-old US volunteers sampled in the US National Health and Nutrition Examination Survey, in the years 2005-2010. To determine reference intervals of typical US patients visiting their clinician, we used minimal exclusion criteria. We compiled hemoglobin, red blood cell count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration, mean cell hemoglobin (MCH), red cell distribution width (RDW), platelet count, mean platelet volume, and counts of white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils, and basophils. In addition, we also compiled serum C reactive protein and serum iron. The three major US races were studied and reference interval diagrams were constructed for each CBC parameter plotted against WC. WBC count, RDW, lymphocyte, neutrophil, and red blood cell count increase with WC. Conversely, serum iron and MCH and MCV decrease. These relationships may be related to insulin resistance and chronic activation of the immune system and the resulting low-grade inflammatory state. WC is a strong predictor for many CBC parameters, suggesting that WC should be taken into account when evaluating blood count results. Clinicians who take care of obese patients should be aware of altered hematology and investigate and treat accordingly.

Associations of Platelet Indices with Body Fat Mass and Fat Distribution

“…In accordance, it has also been reported that other bioactive mediators that are induced by fat tissues, such as adiponectin, may influence platelet production and responses . RBC parameters have been reported to be associated with WC , but additionally adjusting RBC parameters separately did not change the results. These results suggest that the associations between platelet indices and body fat are not influenced by RBCs.…”

Causes of Variation in The Neutrophil–Lymphocyte and Platelet–Lymphocyte Ratios: a Twin-Family Study

“…Positive associations between BMI and NLR were observed in two nonpatient populations [8,9], but a third study did not find BMI to be related to NLR nor to PLR [19]. With respect to their subcomponents, larger waist circumference has been related to higher levels of lymphocytes, neutrophils and platelets [20], and these cell counts were also increased in obese women compared with nonobese women [21,22]. Smoking has also been related to increased NLR in two studies in the general population [8,23] and to increased neutrophil [23] and lymphocyte counts [24].…”

Relação Entre Indicadores Antropométricos E Hematológicos De Pais E Seus Filhos

“…Outros autores não encontraram relação da CC e do IMC com parâmetros hematológicos em italianos, mas após um ajuste com as variáveis sexo, idade e o hábito de fumar, encontraram uma relação positiva entre eles, o que foi atribuído à gordura abdominal e marcadores de resistência à insulina 6 . Um estudo encontrou uma relação positiva entre CC e hemácias, hemoglobina e hematócrito em americanos voluntários do US National Health and Nutrition Examination Survey (NHANES) 15 . Outro, encontrou associação entre hemácias, hematócrito e hemoglobina e índices de IMC e RQC em adultos chineses 16 .…”