Relationship between insulin resistance and hematological parameters in patients with metabolic syndrome

Аннотация

It has already been demonstrated that insulin resistance (IR) is associated with the stimulation of erythroid progenitors and with increased levels of inflammation markers. Therefore, IR should also be associated with increased red blood cell (RBC) and white blood cell (WBC) count. The aim of this study is to demonstrate that IR is independently associated with altered hematological parameters in patients with metabolic syndrome. We analyzed laboratorial exams from 275 subjects. All data on hematological parameters, insulin resistance (Homeostasis Model Assessment [HOMA]) and lipid levels were included in the analysis. Demographic information included age and gender. HOMA correlated positively with RBC (r= 0.17, p< 0.001), plasma hemoglobin concentrations (r= 0.14, p< 0.001), hematocrit value (r= 0.15, p< 0.001) and WBC (r= 0.17, p< 0.01). Subjects in the upper quartile of IR had higher levels of plasma glucose, fasting insulin, triglycerides, hematocrit, hemoglobin, RBC and WBC count than those in the lower quartile. In conclusion, IR seems to be associated with alterations in several hematological parameters. These hematological alterations may be considered an indirect feature of the IR syndrome. Keywords: Insulin resistance, hyperinsulinemia, hemoglobin, red blood cells, white blood cells. hematological parameters could be included as a new Introduction: The metabolic syndrome (MS) is and indirect feature of the IR. We aimed at currently described as the association of insulin demonstrating that IR is independently associated with resistance with obesity (mainly visceral), hypertension, alterations in hematological parameters and and dyslipidemia (increased triglycerides and/or dyslipidemia in patients with metabolic syndrome. decreased HDL-cholesterol). According to WHO criteria [14], insulin resistance (IR) is the main determinant of METHODS the syndrome and hyperinsulinemia, its major clinical For the purpose of this study, we analyzed the results expression, is directly related to all other minor criteria. of laboratorial exams from 275 subjects sequentially Patients with MS are at increased risk for selected between 18 and 80 years old. All patients had cardiovascular death and hyperinsulinemia seems to be a blood sample collected at the Republican scientific an independent factor for a cardiovascular event [8]. center for emergency medical care laboratory to The association between hyperinsulinemia and perform exams for the evaluation of hematological cardiovascular disease is partially explained by the parameters, lipid profile and insulin resistance. Thirty- effects of insulin on cell growth. Insulin has been shown two patients were excluded: 29 subjects because of to promote growth of vascular cells and consequently fasting glucose levels higher than 126 mg/dl (i.e. to induce atherosclerosis. Moreover, several authors Diabetes Mellitus) and 3 subjects becauseof insulin have already demonstrated that insulin also regulates levels higher than 100 μUI/ml. The final analysis erythropoiesis in vitro [3,7]. Recently, it was suggested included 91 men and 152 women with a mean age of that the effects of hyperinsulinemia in erythroid 43.8 ± 15.3 years old. Venous blood samples were progenitors could also lead to an increase in red blood collected after a 12 hr fasting period. Blood glucose was cell (RBC) count [2]. Therefore, the alterations in measured by an enzymatic colorimetric assay using International Journal of Medical Sciences And Clinical Research 16 https://theusajournals.com/index.php/ijmscr International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265) glucose oxidase method and plasma insulin by a evaluated by means of the Spearman's rank order commercial double-antibody, solid phase correlation coefficient. Multivariate linear regression radioimmunoassay. Commercial enzymatic tests were analysis was used to test the independent association used for determining serum total- and HDL cholesterol of age, gender and HOMA with the hematological and triglyceride concentrations. Serum LDL cholesterol parameters. The level of statistical significance was 5%. concentrations were calculated by the Friedwald