Abstract

ObjectiveIncrements in red blood cell count (RBC), hemoglobin (Hb) and hematocrit (Ht) levels are reportedly associated with higher insulin resistance (IR). Obesity may cause IR, but underlying factors remain incompletely defined, and interactions between obesity, hematological parameters and IR are incompletely understood. We therefore determined whether: 1) BMI and obesity per se are independently associated with higher RBC, hemoglobin and hematocrit; 2) hematological parameters independently predict insulin resistance in obese individuals.Design and MethodsWe investigated the associations between BMI, hematological parameters and insulin resistance as reflected by homeostasis model assessment (HOMA) in a general population cohort from the North-East Italy MoMa epidemiological study (M/F = 865/971, age = 49±1).ResultsIn all subjects, age-, sex- and smoking-adjusted hematological parameters were positively associated with BMI in linear regression (P<0.05), but not after adjustment for HOMA or waist circumference (WC) and potential metabolic confounders. No associations were found between hematological parameters and BMI in lean, overweight or obese subgroups. Associations between hematological parameters and HOMA were conversely independent of BMI in all subjects and in lean and overweight subgroups (P<0.01), but not in obese subjects alone.ConclusionsIn a North-East Italy general population cohort, obesity per se is not independently associated with altered RBC, Hb and Ht, and the association between BMI and hematological parameters is mediated by their associations with abdominal fat and insulin resistance markers. High hematological parameters could contribute to identify insulin resistance in non-obese individual, but they do not appear to be reliable insulin resistance biomarkers in obese subjects.

Highlights

  • Obesity is a major risk factor for insulin resistance [1,2], but factors linking obesity and increased insulin resistance are not completely understood [1,2,3]

  • In all subjects, age, sex- and smoking-adjusted hematological parameters were positively associated with body mass index (BMI) in linear regression (P,0.05), but not after adjustment for homeostasis model assessment (HOMA) or waist circumference (WC) and potential metabolic confounders

  • In a North-East Italy general population cohort, obesity per se is not independently associated with altered red blood cells (RBC), Hb and Ht, and the association between BMI and hematological parameters is mediated by their associations with abdominal fat and insulin resistance markers

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Summary

Introduction

Obesity is a major risk factor for insulin resistance [1,2], but factors linking obesity and increased insulin resistance are not completely understood [1,2,3]. Evidence is lacking on the potential impact of obesity per se on hematological parameters and on potential involvement of hematological parameters in obesity-associated insulin resistance. We investigated the associations between body mass index (BMI), hematological parameters and insulin resistance, calculated using the validated homeostasis model assessment (HOMA) index [11], in a cohort from the MoMa study, an epidemiological investigation aimed at assessing the prevalence of obesity in the North-East Italy Friuli-Venezia Giulia Region. In the whole cohort and in lean, overweight or obese individuals, we sought to determine whether or not 1) BMI and obesity per se are independently associated with higher RBC, hemoglobin and hematocrit and 2) hematological parameters are potential independent predictors of insulin resistance in obese individuals

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