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Is an elevated hemoglobin concentration a novel risk factor for metabolic syndrome in the Chinese population a largescale study

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Xiao-Dong Zhou1,*, Sheng-Jie Wu1,*, Li-Ren Wang2,3, Wen-Yue Liu4, Ji-Na Zheng2,3, Ke-Qing Shi2,5, Sven Van Poucke6, Dong-Chu Zhang7, Wei-Jian Huang1, Ming-Hua Zheng2,5

1Department of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

2Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

3School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China

4Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

5Institute of Hepatology, Wenzhou Medical University, Wenzhou, China

6Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium

7Wenzhou Medical Center, Wenzhou People’s Hospital, Wenzhou, China

*Co-first author

Correspondence to:

Ming-Hua Zheng, email: [email protected]

Wei-Jian Huang, email: [email protected]

Keywords: hemoglobin, metabolic syndrome, risk factor, health examination, longitudinal population

Received: April 10, 2016    Accepted: June 30, 2016    Published: July 13, 2016

ABSTRACT

Objectives: The potential role of elevated hemoglobin concentration in the development of metabolic syndrome (MS) has not been adequately evaluated. We aim to determine the role of elevated hemoglobin concentrations as a risk factor in MS during health examination of Chinese individuals.

Methods: 57,510 health check-up (45,451 by cross-sectional study and 12,059 in a longitudinal population) were conducted. Subjects were divided into quartiles for analyses, using multiple logistic analyses. Furthermore, the logistic analyses were used to explore the association between hemoglobin concentration and individual MS components respectively in the cross-sectional study and the longitudinal study.

Results: In this cross-sectional study, 10.4% of 45,451 of the health checkup subjects developed MS. Multiple logistic analysis revealed that higher hemoglobin quartiles were positively associated with the development of MS which was in contrast to the lowest hemoglobin quartiles in the fully adjusted model (OR: 2.171, 95% CI 1.944 - 2.424 in males, P < 0.001; 2.694, 95% CI 2.056 - 3.531 in females, P < 0.001). In addition, during a five-year period, 10.8% of 12,059 health checkup subjects in a longitudinal study were identified. When adjustments were made for compounding factors, the HR for this association between MS and hemoglobin persisted (HR: 2.157, 95% CI 1.635 - 2.847, P < 0.001).

Conclusions: Serum hemoglobin levels were associated with the prevalence of MS in Chinese individuals, suggesting that serum hemoglobin levels might be a novel predictor for the incidence of MS.