Hemorheological alterations in adults with prediabetes identified by hemoglobin A1c levels

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2017-07, Vol.27 (7), p.601-608
• Main Authors: Marini, M.A., Fiorentino, T.V., Andreozzi, F., Mannino, G.C., Succurro, E., Sciacqua, A., Perticone, F., Sesti, G.
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers - blood; Blood Viscosity; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Cardiovascular risk; Carotid Intima-Media Thickness; Case-Control Studies; Cross-Sectional Studies; Female; Glucose Tolerance Test; Glycated Hemoglobin A - analysis; HbA1c; Hematocrit; Hemorheology; Humans; Male; Middle Aged; Prediabetes; Prediabetic State - blood; Prediabetic State - complications; Prediabetic State - diagnosis; Prediabetic State - physiopathology; Predictive Value of Tests; Prognosis; Risk Factors
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2017.04.001

A link between increased blood viscosity and type 2 diabetes has been previously reported. Herein, we investigated the association of blood viscosity with prediabetes, identified by glycated hemoglobin A1c (HbA1c) according to the new American Diabetes Association criteria, and subclinical atherosclerosis. The study cohort includes 1136 non-diabetic adults submitted to anthropometrical evaluation, an oral glucose tolerance test and ultrasound measurement of carotid intima-media thickness (IMT). Whole blood viscosity was estimated using a validated formula based on hematocrit and total plasma proteins. After adjusting for age, and gender, individuals with HbA1c-defined prediabetes (HbA1c 5.7–6.4% [39–47 mmol/mol]) exhibited significantly higher values of hematocrit, and predicted blood viscosity as compared with controls. Increased levels of IMT were observed in subjects with HbA1c-defined prediabetes in comparison to controls. Predicted blood viscosity was positively correlated with age, waist circumference, blood pressure, cholesterol, triglycerides, fibrinogen, white blood cell, HbA1c, fasting and 2-h post-load glucose levels, fasting insulin, IMT and inversely correlated with HDL and Matsuda index of insulin sensitivity. Of the three glycemic parameters, i.e. HbA1c, fasting and 2-h post-load glucose, only HbA1c showed a significant correlation with predicted blood viscosity (β = 0.054, P = 0.04) in a multivariate regression analysis model including multiple atherosclerosis risk factors. The study shows that individuals with HbA1c-defined prediabetes have increased predicted blood viscosity and IMT. The HbA1c criterion may be helpful to capture individuals with an increased risk of diabetes and cardiovascular disease who may benefit from an intensive lifestyle intervention. •Subjects with HbA1c-defined prediabetes have increased blood viscosity and hematocrit.•HbA1c is an independent contributor of blood viscosity and hematocrit.•Blood viscosity and hematocrit are associated with carotid intima-media thickness.•Carotid intima-media thickness is increased in subjects with HbA1c-defined prediabetes.•A HbA1c value of 5.7–6.4% may identify subjects with increased cardio-metabolic risk.