Hypercholesterolemia associated with erythrocytes morphology assessed by scanning electron microscopy in metabolically unhealthy individuals with normal-weight and obesity

Abstract

AimsTo associate hypercholesterolemia and obesity with red blood cell (RBC) morphology as assessed by scanning electron microscopy (SEM) in metabolically healthy and unhealthy adults with normal weight and with obesity. MethodsCross-sectional study with four groups: metabolically healthy with normal-weight (MHNW, n = 12), metabolically unhealthy with normal-weight (MUNW, n = 5), metabolically healthy with obesity (MHO, n = 4), and metabolically unhealthy with obesity (MUO, n = 6). SEM was used to assess the RBC morphology (diameter, height, and axial ratio, n = 810 cells). SEM images were analyzed using Gwyddion software to measure the RBC morphology parameters. ResultsSEM images showed altered RBC morphologies in the MUNW, MHO, and MUO groups. Diameter and axial ratio were statistically different after comparison of MHNW vs. MUNW (+0.41 μm, +0.05 μm); MUNW vs. MHO (−0.70 μm, −0.05 μm); and MHO vs. MUO (+0.38 μm, +0.04 μm), respectively. Hypercholesterolemia was associated with larger and more elongated RBC, while obesity with smaller RBC. Besides, age, HDL, ultra-processed food consumption were associated with altered RBC morphology. ConclusionsSEM is an excellent instrument to assess qualitatively and quantitatively RBC morphology. Hypercholesterolemia and obesity had a negative effect on the RBC morphology, but producing different effects on the RBC morphology (larger and smaller RBC, respectively).