title: Association of hemoglobin with ankle-brachial index in general population.
abstract: OBJECTIVE
  Previous studies have demonstrated that both low and high hemoglobin concentrations are predictive of adverse cardiovascular outcomes in various populations. However, an association of hemoglobin with the ankle-brachial index, which is widely used as a screening test for peripheral arterial disease, has not yet been identified.
  
  
  METHODS
  We examined 786 subjects (236 women and 550 men) who received routine physical check-ups. The ankle-brachial index and several hematological parameters, including the hemoglobin level, hematocrit and red blood cell count and other demographic and biochemical characteristics were collected. Univariate and multivariate linear regression analyses were performed to assess the relationships between the ankle-brachial index and the independent determinants. Receiver operating characteristic curve analysis was conducted to calculate the cut-off level of hemoglobin for detecting a relatively low ankle-brachial index (less than 20% of all subjects, which was 1.02).
  
  
  RESULTS
  The hemoglobin level, hematocrit and red blood cell count were correlated with the ankle-brachial index in the males (r=-0.274, r=-0.224 and r=-0.273, respectively, p<0.001 for all), but these associations were not significant in the females. Multivariate linear regression analysis revealed that the independent determinants of the ankle-brachial index included age, total cholesterol, high-density lipoprotein cholesterol and the white blood cell count for the females and age, hypertension, total cholesterol and hemoglobin (β=-0.001, p<0.001) for the males after adjusting for confounding factors. Receiver operating characteristic curve analysis revealed that the cut-off level of hemoglobin for predicting a low ankle-brachial index was 156.5 g/L in the males.
  
  
  CONCLUSIONS
  A high hemoglobin concentration was independently correlated with a low ankle-brachial index in the healthy males, indicating that an elevation in this level may be associated with an increased atherosclerosis risk.
authors.affiliation: Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Chenglong
authors.affiliation: Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China.
authors.forename: Lei
authors.initials: L
authors.lastname: Jing
authors.affiliation: Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China.
authors.forename: Ke
authors.initials: K
authors.lastname: Xia
authors.affiliation: Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China.
authors.forename: Tianlun
authors.initials: T
authors.lastname: Yang
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index / Q000379:methods*; D001772:Blood Cell Count; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D006973:Hypertension / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood
chemical_list: D006454:Hemoglobins; D014280:Triglycerides; D014527:Uric Acid; D002784:Cholesterol