Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Association between erythrocyte parameters and metabolic syndrome in urban Han Chinese: a longitudinal cohort study

Authors: Shuo Wu, Haiyan Lin, Chengqi Zhang, Qian Zhang, Dongzhi Zhang, Yongyuan Zhang, Wenjia Meng, Zhenxin Zhu, Fang Tang, Fuzhong Xue, Yanxun Liu

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

Although various cross-sectional studies have shown that erythrocyte parameters, including red blood cell (RBC), hemoglobin (Hb) and hematocrit (HCT), were linked with metabolic syndrome (MetS), few longitudinal studies have been used to confirm their relationship. The study, therefore, constructed a large-scale longitudinal cohort in urban Chinese population to highlight and confirm the association between erythrocyte parameters and MetS/its components.

Methods

A longitudinal cohort with 6,453 participants was established based on the routine health check-up systems to follow up MetS, and Generalized Estimating Equation (GEE) model was used to detect the association between erythrocyte parameters and MetS/its components (obesity, hyperglycemia, dyslipidemia, and hypertension).

Results

287 MetS occurred over the four-year follow-up, leading to a total incidence density of 14.19 per 1,000 person-years (287/20218 person-years). Both RBC and Hb were strongly associated with MetS (RR/95% CI, P value; 3.016/1.525-5.967, 0.002 for RBC; 3.008/1.481-6.109, 0.002 for Hb), with their dose–response trends detected. All three erythrocyte parameters (RBC, Hb and HCT) were found to be associated with obesity, hypertension and dyslipidemia with similar dose–response trends respectively, while only Hb showed a significant association with hyperglycemia.

Conclusions

Elevated erythrocyte parameters were confirmed to be associated with MetS/its components in urban Chinese population, suggesting that erythrocyte parameters might be served as a potential predictor for risk of MetS.
Appendix
Available only for authorised users
Literature
1.
Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C, Conference P: Definition of metabolic syndrome - Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circ. 2004, 109 (3): 433-438. 10.1161/01.CIR.0000111245.75752.C6.CrossRef
2.
Wang Y-Y, Lin S-Y, Liu P-H, Cheung BMH, Lai W-A: Association between hematological parameters and metabolic syndrome components in a Chinese population. J Diabetes Complications. 2004, 18 (6): 322-327. 10.1016/S1056-8727(04)00003-0.CrossRefPubMed
3.
Mardi T, Toker S, Melamed S, Shirom A, Zeltser D, Shapira I, Berliner S, Rogowski O: Increased erythropoiesis and subclinical inflammation as part of the metabolic syndrome. Diabetes Res Clin Pract. 2005, 69 (3): 249-255. 10.1016/j.diabres.2005.01.005.CrossRefPubMed
4.
Kim JA, Choi YS, Hong JI, Kim SH, Jung HH, Kim SM: Association of metabolic syndrome with white blood cell subtype and red blood cells (Retracted Article. See vol 53, pg 871, 2006). Endocr J. 2006, 53 (1): 133-139. 10.1507/endocrj.53.133.CrossRefPubMed
5.
Kotani K, Sakane N, Kurozawa Y: Increased Red Blood Cells in Patients with Metabolic Syndrome. Endocr J. 2006, 53: 713-714. 10.1507/endocrj.K06-110.CrossRef
6.
Kawamoto R, Tabara Y, Kohara K, Miki T, Kusunoki T, Abe M, Katoh T: Hematological parameters are associated with metabolic syndrome in Japanese community-dwelling persons. Endocrine. 2013, 43 (2): 334-341. 10.1007/s12020-012-9662-7.CrossRefPubMed
7.
Lohsoonthorn V, Jiamjarasrungsi W, Williams MA: Association of hematological parameters with clustered components of metabolic syndrome among professional and office workers in Bangkok, Thailand. Diabetes Metab Clin Res Rev. 2007, 1 (3): 143-149. 10.1016/j.dsx.2007.05.002.CrossRef
8.
Sugimori H, Tomoda F, Koike T, Kinuno H, Kurosaki H, Masutani T, Inoue H: Blood Rheology and Platelet Function in Untreated Early-Stage Essential Hypertensives Complicated with Metabolic Syndrome. Int J Hypertens. 2012, 2012: 1-5.CrossRef
9.
Nebeck K, Gelaye B, Lemma S, Berhane Y, Bekele T, Khali A, Haddis Y, Williams MA: Hematological parameters and metabolic syndrome: Findings from an occupational cohort in Ethiopia. Diabetes Metab Clin Res Rev. 2012, 6 (1): 22-27. 10.1016/j.dsx.2012.05.009.CrossRef
10.
Tabara Y, Igase M, Saito I, Nishida W, Kohara K, Sakurai S, Kawamura R, Okada Y, Hitsumoto S, Onuma H, et al: ssociation of hematological parameters with insulin resistance, insulin sensitivity, and asymptomatic cerebrovascular damage: The J-SHIP Toon Health Study. Clin Hemorheol Microcirc. 2012, Epub ahead of print
11.
Rochon J: Application of GEE procedures for sample size calculations in repeated measures experiments. Stat Med. 1998, 17 (14): 1643-1658. 10.1002/(SICI)1097-0258(19980730)17:14<1643::AID-SIM869>3.0.CO;2-3.CrossRefPubMed
12.
Lee J-H, Herzog TA, Meade CD, Webb MS, Brandon TH: The use of GEE for analyzing longitudinal binomial data: A primer using data from a tobacco intervention. Addict Behav. 2007, 32 (1): 187-193. 10.1016/j.addbeh.2006.03.030.CrossRefPubMed
13.
Lin K-C, Chen Y-J, Shyr Y: A nonparametric smoothing method for assessing GEE models with longitudinal binary data. Stat Med. 2008, 27 (22): 4428-4439. 10.1002/sim.3315.CrossRefPubMed
14.
Hubbard AE, Ahern J, Fleischer NL, Van der Laan M, Lippman SA, Jewell N, Bruckner T, Satariano WA: To GEE or Not to GEE Comparing Population Average and Mixed Models for Estimating the Associations Between Neighborhood Risk Factors and Health. Epidemiol. 2010, 21 (4): 467-474. 10.1097/EDE.0b013e3181caeb90.CrossRef
15.
Lu Y-h, Lu J-m, Wang S-y, Li C-l, Liu L-s, Zheng R-p, Tian H, Wang X-l, Yang L-j, Zhang Y-q, et al: Comparison of the diagnostic criteria of metabolic syndrome by International Diabetes Federation and that by Chinese Medical Association Diabetes Branch. Zhonghua yi xue za zhi. 2006, 86 (6): 386-389.PubMed
16.
Schafer J: Multiple imputation: a primer. Stat Methods Medods Res. 1999, 8: 3-15. 10.1191/096228099671525676.CrossRef
17.
Bersch N, Groopman JE, Golde DW: Natural and biosynthetic insulin stimulates the growth of human erythroid progenitors in vitro. J Clin Endocrinol Metab. 1982, 55 (6): 1209-1211. 10.1210/jcem-55-6-1209.CrossRefPubMed
18.
Dainiak N, Kreczko S: Interactions of insulin, insulinlike growth factor II, and platelet-derived growth factor in erythropoietic culture. J Clin Invest. 1985, 76 (3): 1237-1242. 10.1172/JCI112079.CrossRefPubMedPubMedCentral
19.
Sawada K, Krantz SB, Dessypris EN, Koury ST, Sawyer ST: Human colony-forming units-erythroid do not require accessory cells, but do require direct interaction with insulin-like growth factor I and/or insulin for erythroid development. J Clin Invest. 1989, 83 (5): 1701-1709. 10.1172/JCI114070.CrossRefPubMedPubMedCentral
20.
Ratajczak J, Zhang Q, Pertusini E, Wojczyk BS, Wasik MA, Ratajczak MZ: The role of insulin (INS) and insulin-like growth factor-I (IGF-I) in regulating human erythropoiesis. Studies in vitro under serum-free conditions - comparison to other cytokines and growth factors. Leuk. 1998, 12 (3): 371-381. 10.1038/sj.leu.2400927.CrossRef
21.
Miyagawa S, Kobayashi M, Konishi N, Sato T, Ueda K: Insulin and insulin-like growth factor I support the proliferation of erythroid progenitor cells in bone marrow through the sharing of receptors. Br J Haematol. 2000, 109 (3): 555-562. 10.1046/j.1365-2141.2000.02047.x.CrossRefPubMed
22.
Widness JA, Susa JB, Garcia JF, Singer DB, Sehgal P, Oh W, Schwartz R, Schwartz HC: Increased erythropoiesis and elevated erythropoietin in infants born to diabetic mothers and in hyperinsulinemic rhesus fetuses. J Clin Invest. 1981, 67 (3): 637-642. 10.1172/JCI110078.CrossRefPubMedPubMedCentral
23.
Stonestreet BS, Goldstein M, Oh W, Widness JA: Effects of prolonged hyperinsulinemia on erythropoiesis in fetal sheep. Am J Physiol. 1989, 257 (5 Pt 2): R1199-1204.PubMed
24.
Petakov M, Biljanovic-Paunovic L, Jovcic G, Stojanovic N, Todorovic V, Jelkmann W: The influence of acute sterile inflammation on erythropoiesis in rats. Exp Hematol. 1998, 26 (3): 222-227.PubMed
25.
Zinchuk VV, Pronko TP, Lis MA: Blood oxygen transport and endothelial dysfunction in patients with arterial hypertension. Clin Physiol Funct Imaging. 2004, 24 (4): 205-211. 10.1111/j.1475-097X.2004.00549.x.CrossRefPubMed
26.
Kelm M, Rath J: Endothelial dysfunction in human coronary circulation: relevance of the L-arginine-NO pathway. Basic Res Cardiol. 2001, 96 (2): 107-127. 10.1007/s003950170061.CrossRefPubMed
27.
Singel DJ, Stamler JS: Chemical physiology of blood flow regulation by red blood cells: The role of nitric oxide and S-nitrosohemoglobin. Annu Rev Physiol. 2005, 67: 99-145. 10.1146/annurev.physiol.67.060603.090918.CrossRefPubMed
28.
Wei Y, Liu G, Yang J, Zheng R, Jiang L, Bao P: The association between metabolic syndrome and vascular endothelial dysfunction in adolescents. Exp Ther Med. 2013, 5 (6): 1663-1666.PubMedPubMedCentral
29.
Facchini FS, Carantoni M, Jeppesen J, Reaven GM: Hematocrit and hemoglobin are independently related to insulin resistance and compensatory hyperinsulinemia in healthy, non-obese men and women. Metabolism. 1998, 47 (7): 831-835. 10.1016/S0026-0495(98)90121-4.CrossRefPubMed
30.
Nakanishi N, Suzuki K, Tatara K: Haematocrit and risk of development of Type 2 diabetes mellitus in middle-aged Japanese men. Diabetic Med. 2004, 21 (5): 476-482. 10.1111/j.1464-5491.2004.01152.x.CrossRefPubMed
31.
Tamariz LJ, Young JH, Pankow JS, Yeh H-C, Schmidt MI, Astor B, Brancati FL: Blood Viscosity and Hematocrit as Risk Factors for Type 2 Diabetes Mellitus. Am J Epidemiol. 2008, 168 (10): 1153-1160. 10.1093/aje/kwn243.CrossRefPubMedPubMedCentral
Metadata
Title
Association between erythrocyte parameters and metabolic syndrome in urban Han Chinese: a longitudinal cohort study
Authors
Shuo Wu
Haiyan Lin
Chengqi Zhang
Qian Zhang
Dongzhi Zhang
Yongyuan Zhang
Wenjia Meng
Zhenxin Zhu
Fang Tang
Fuzhong Xue
Yanxun Liu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-989

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue

Research article

Associations between employee and manager gender: impacts on gender-specific risk of acute occupational injury in metal manufacturing

Research article

The impact of the UK ‘Act FAST’ stroke awareness campaign: content analysis of patients, witness and primary care clinicians’ perceptions

Research article

Childhood adversity as a risk for cancer: findings from the 1958 British birth cohort study

Research article

Diabetes in the workplace - diabetic’s perceptions and experiences of managing their disease at work: a qualitative study

Research article

A prospective cohort study of disability pension due to mental diagnoses: the importance of health factors and behaviors

Research article

Maternal HIV disclosure to HIV-uninfected children in rural South Africa: a pilot study of a family-based intervention