Combined effect of hemoglobin and mean corpuscular volume levels on incident metabolic syndrome: A population-based cohort study

Clinical features and risk factors for appendiceal diverticulitis: a comparative study with acute appendicitis

PURPOSE

Despite their similar clinical characteristics, appendiceal diverticulitis (AD) and acute appendicitis (AA) are pathologically distinct. This study compared the clinical features of AD and AA and identified relevant risk factors.

METHODS

Patients who underwent appendectomy with a preoperative diagnosis of either AD or AA were categorized based on histopathological findings. The two groups were compared in terms of various clinical factors.

RESULTS

Among the 854 patients included in the study, a histopathological evaluation revealed 49 and 805 cases of AD and AA, respectively. A univariate analysis demonstrated that AD was more prevalent than AA among older, taller, and heavier males. A multivariate analysis revealed that male sex, a white blood cell (WBC) count < 13.5 × 103/μL, an eosinophil count ≥ 0.4%, and a mean corpuscular volume (MCV) ≥ 91.6 fL were significant factors differentiating AD from AA. In addition, pathological AD emerged as an independent risk factor for abscess and/or perforation.

CONCLUSIONS

AD was associated with an older age, robust physique, and significant risk of abscess and/or perforation despite a low WBC count. In addition to imaging modalities, the preoperative factors of male sex, a WBC count < 13.5 × 103/μL, an eosinophil count ≥ 0.4%, and a MCV ≥ 91.6 fL may be useful for distinguishing AD from AA.

Causal links of α-thalassemia indices and cardiometabolic traits and diabetes: MR study

Our study aimed to investigate if genetic variants around 16p13.3's HBA1 locus, associated with erythrocyte indices and HbA1c levels, predict α-thalassemia-related erythrocyte indices, cardiometabolic traits, and diabetes risk in Taiwanese individuals. We analyzed Taiwan Biobank data, including whole-genome sequencing from 1,493 participants and genotyping arrays from 129,542 individuals. First, we performed regional association analysis using whole-genome sequencing data to identify genetic variants significantly associated with erythrocyte indices, confirming their linkage disequilibrium with the α0 thalassemia --SEA deletion mutation, a common cause of α-thalassemia in Southeast Asian populations. Deletion mutation sequencing further validated these variants' association with α-thalassemia. Subsequently, we analyzed genotyping array data, revealing associations between specific genetic variants and cardiometabolic traits, including lipid profiles, HbA1c levels, bilirubin levels, and diabetes risk. Using Mendelian randomization, we established causal relationships between α-thalassemia-related erythrocyte indices and cardiometabolic traits, elucidating their role in diabetes susceptibility. Our findings highlight genetic variants around the α-globin genes as surrogate markers for common α-thalassemia mutations in Taiwan, emphasizing the causal links between α-thalassemia-related erythrocyte indices, cardiometabolic traits, and heightened diabetes risk.

Association between Metabolic Syndrome and Leukocytes: Systematic Review and Meta-Analysis

Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by central obesity, hypertension, dyslipidaemia, and dysregulation of blood glucose, which is associated with the risk of diabetes, cardiovascular disease, and overall mortality. White blood cell count is a selective marker of acute infection and inflammation, which could provide information on the metabolic status of subjects. This study aims to provide the best evidence on the association between MetS and white blood cell count by determining the effect size of this biomarker. Methods: A systematic review and meta-analysis of studies indexed in the PubMed and Scopus databases were performed. Methodological quality was assessed using the STROBE tool, overall risk of bias using RevMan (Cochrane Collaboration), and quality of evidence using Grade Pro. Results: We included 14 articles comparing leukocyte concentrations in 21,005 subjects with MetS and 66,339 controls. Subjects with MetS had a higher mean leukocyte count, 0.64 cells ×109/L; CI95% 0.55-0.72; p < 0.00001; I2 = 93%. Conclusions: An in-depth evaluation of the relationship of leukocytes in the pathophysiological process of MetS could lead to new insights into early diagnosis.

Correlation Between Hemoglobin Levels and Polycystic Ovary Syndrome Metabolic Disorder

Objective

The purpose of this study was to explore the relationship between hemoglobin levels and metabolic disorders in patients with PCOS.

Methods

A total of 573 patients were selected, based on the hemoglobin level; 342 patients with PCOS were divided into two groups as follows: Group A (normal Hb group, n = 269) and Group B (high Hb group, n = 73); 231 non-PCOS patients were divided into two groups as follows: Group C (normal Hb group, n = 199), and Group D (high Hb group, n = 32). The general information, glucose and lipid metabolism indicators, and uric acid levels of all patients were compiled for data analysis.

Results

(1) Hb, HGB concentration in mean red blood cells and RDW in PCOS patients were higher than those in non-PCOS patients, and MCV was lower than that in non-PCOS patients (P < 0.05); (2) Compared with Group A, patients in Group B had higher BMI, Hb, 2-hPG, FINS, 2-hINS, HOMA-IR, LDL-C, and uric acid levels while the QUICKI was lower; in Group C, the age, FSH, HDL-C, and LDL-C were higher, and AMH, BMI, T, TG, and uric acid level were lower (P<0.05); compared with Group D, AMH, BMI, FINS, HOMA-IR, TG, uric acid level increased, while age, FSH, and QUICKI decreased in Group B; and Hb and T decreased in Group C (P<0.05); (3) Pearson's correlation analysis indicated that Hb in PCOS patients was positively correlated with BMI, FPG, 2-hPG, FINS, 2-hINS, and HOMA-IR, and negatively correlated with the QUICKI (P<0.05); (4) Multi-factor logistic regression analysis suggested that the high Hb level in PCOS patients was an independent risk factor of IR (P<0.05).

Conclusion

Hb level in patients with PCOS was associated with BMI and glucose metabolism indicators; a high Hb level may be an independent risk factor for IR.

A Mendelian randomization-based exploration of red blood cell distribution width and mean corpuscular volume with risk of hemorrhagic strokes

Red blood cell distribution width (RCDW) and mean corpuscular volume (MCV) are associated with different risk factors for hemorrhagic stroke. However, whether RCDW and MCV are causally related to hemorrhagic stroke remains poorly understood. Therefore, we explored the causality between RCDW/MCV and nontraumatic hemorrhagic strokes using Mendelian randomization (MR) methods. We extracted exposure and outcome summary statistics from the UK Biobank and FinnGen. We evaluated the causality of RCDW/MCV on four outcomes (subarachnoid hemorrhage [SAH], intracerebral hemorrhage [ICH], nontraumatic intracranial hemorrhage [nITH], and a combination of SAH, cerebral aneurysm, and aneurysm operations) using univariable MR (UMR) and multivariable MR (MVMR). We further performed colocalization and mediation analyses. UMR and MVMR revealed that higher genetically predicted MCV is protective of ICH (UMR: odds ratio [OR] = 0.89 [0.8-0.99], p = 0.036; MVMR: OR = 0.87 [0.78-0.98], p = 0.021) and nITH (UMR: OR = 0.89 [0.82-0.97], p = 0.005; MVMR: OR = 0.88 [0.8-0.96], p = 0.004). There were no strong causal associations between RCDW/MCV and any other outcome. Colocalization analysis revealed a shared causal variant between MCV and ICH; it was not reported to be associated with ICH. Proportion mediated via diastolic blood pressure was 3.1% (0.1%,14.3%) in ICH and 3.4% (0.2%,15.8%) in nITH. The study constitutes the first MR analysis on whether genetically elevated RCDW and MCV affect the risk of hemorrhagic strokes. UMR, MVMR, and mediation analysis revealed that MCV is a protective factor for ICH and nITH, which may inform new insights into the treatments for hemorrhagic strokes.