Association of hematological parameters with insulin resistance, insulin sensitivity, and asymptomatic cerebrovascular damage: The J-SHIP and Toon Health Study

作者：Tabara Yasuharu^*; Igase Michiya; Saito Isao; Nishida Wataru; Kohara Katsuhiko; Sakurai Susumu; Kawamura Ryoichi; Okada Yoko; Hitsumoto Shinichi; Onuma Hiroshi; Nagai Tokihisa; Takata Yasunori; Uetani Eri; Takita Rie; Kido Tomoko; Ochi Namiko; Osawa Haruhiko; Tanigawa Takeshi; Miki Tetsuro

来源：Clinical Hemorheology and Microcirculation, 2013, 55(3): 297-311.

DOI：10.3233/CH-2012-1634

• Hematocrit
• insulin resistance
• atherosclerosis
• cerebrovascular disease

BACKGROUND: Elevated hematocrit levels have been suggested to be an independent determinant of insulin resistance and type 2 diabetes. To clarify the diagnostic significance of hematocrit level, we investigated the association with hemodynamic profiles, insulin resistance and insulin sensitivity, arterial properties, and asymptomatic cerebrovascular damage in a general Japanese population. %26lt;br%26gt;METHODS: This study included 1,978 participants from two independent cohorts. Insulin sensitivity was assessed by the oral 75 g glucose tolerance test. Carotid ultrasonography was performed to evaluate atherosclerosis and wall shear stress. Periventricular hyperintensity and lacunar infarction were assessed by brain magnetic resonance imaging. %26lt;br%26gt;RESULTS: Hematocrit quartile showed a stepwise association with insulin sensitivity (Q1: 2.2 +/- 0.7, Q2: 2.0 +/- 0.7, Q3: 1.9 +/- 0.7, Q4: 1.8 +/- 0.6, p %26lt; 0.001) and insulin resistance (1.0 +/- 0.6, 1.2 +/- 0.7, 1.3 +/- 0.8, 1.5 +/- 1.0, p %26lt; 0.001). Multiple linear regression analysis adjusted for possible covariates identified hematocrit as an independent determinant of insulin sensitivity (beta = -0.074, p = 0.019) and insulin resistance (beta = 0.115, p %26lt; 0.001). However, this association was lost after further adjustment for visceral fat area and plasma alanine aminotransferase level. Further, no significant association was observed between hematocrit and carotid intima-media thickness (p = 0.306) where as wall shear stress was inversely associated with the carotid atherosclerosis (r = -0.250, p %26lt; 0.001). In contrast, a low hematocrit level was independently associated with periventricular hyperintensity (odds ratio 0.87 (95% CI 0.80-0.95), p = 0.001). %26lt;br%26gt;CONCLUSION: Hematocrit was positively associated with insulin resistance and insulin sensitivity. This association was epiphenomenon of visceral and hepatic adiposity. Conversely, low hematocrit was a significant risk factor for periventricular hyperintensity independent of insulin resistance.

• 出版日期2013