Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Internal Medicine, Matsushita Memorial Hospital, Osaka, Japan.
Clin Nutr ESPEN. 2020 Dec;40:314-319. doi: 10.1016/j.clnesp.2020.08.010. Epub 2020 Sep 8.
BACKGROUND & AIMS: Higher hemoglobin levels are associated with incident metabolic syndrome (MetS), and higher mean corpuscular volume (MCV) is associated with adverse outcomes. The objective of this study is to evaluate the combined effect of MCV and hemoglobin levels on incident MetS.
In our cross-sectional study, we analyzed the prevalence of MetS in 20,162 middle-aged Japanese subjects without anemia and with normal MCV levels, as they underwent physical checkups. We subsequently analyzed incident MetS in 11,110 subjects. In order to evaluate the combined effect on incident MetS, the subjects were divided into four study groups according to cutoff values of hemoglobin and MCV for identifying the prevalence of MetS.
In the cross-sectional study, hemoglobin (adjusted odds ratio [aOR], 1.02; P < 0.0001 in men and OR, 1.04; P < 0.0001 in women, per 1.0 g/L) and MCV (aOR, 0.93; P < 0.0001 in men and OR, 0.94; P = 0.0005 in women, per 1.0 fL) were independently associated with the prevalence of MetS. In the longitudinal cohort study, hemoglobin (adjusted hazards ratio [aHR, 1.12; P = 0.0006, per 1.0 g/L) and MCV (aHR, 0.96; P < 0.0001, per 1.0 fL) were independently associated with incident MetS in men but not in women. Then, the lower hemoglobin/higher MCV group showed decreased HRs for incidence of MetS compared with other groups of men but not of women.
Among the subjects without anemia and with normal MCV levels, higher hemoglobin or lower MCV levels were associated with higher prevalence of MetS in men and women. In addition, lower hemoglobin with higher MCV showed a decreased risk of MetS in men. We suggested that the assessment of hemoglobin and MCV levels could be used as practical screening tool for MetS.
较高的血红蛋白水平与代谢综合征（MetS）的发生有关，较高的平均红细胞体积（MCV）与不良结局有关。本研究的目的是评估 MCV 和血红蛋白水平对代谢综合征发生的联合影响。
在我们的横断面研究中，我们分析了 20162 名无贫血和正常 MCV 水平的中年日本受试者中代谢综合征的患病率，他们接受了体检。随后，我们分析了 11110 名受试者的代谢综合征发病情况。为了评估对代谢综合征发生的联合影响，根据血红蛋白和 MCV 的截断值将受试者分为四个研究组，以确定代谢综合征的患病率。
在横断面研究中，血红蛋白（调整后的优势比[OR]，男性为 1.02；P<0.0001，女性为 1.04；P<0.0001，每增加 1.0 g/L）和 MCV（OR，男性为 0.93；P<0.0001，女性为 0.94；P=0.0005，每增加 1.0 fL）与代谢综合征的患病率独立相关。在纵向队列研究中，血红蛋白（调整后的危险比[aHR]，男性为 1.12；P=0.0006，每增加 1.0 g/L）和 MCV（aHR，男性为 0.96；P<0.0001，每增加 1.0 fL）与男性但不是女性的代谢综合征发病独立相关。然后，与其他男性组相比，血红蛋白较低/MCV 较高的组显示出代谢综合征发病率降低的 HR，但在女性中并非如此。
在无贫血和正常 MCV 水平的受试者中，较高的血红蛋白或较低的 MCV 水平与男性和女性代谢综合征的患病率较高有关。此外，男性中较低的血红蛋白和较高的 MCV 显示出代谢综合征风险降低。我们建议，血红蛋白和 MCV 水平的评估可以作为代谢综合征的实用筛查工具。
