title: Association of Whole Blood Viscosity With Metabolic Syndrome in Type 2 Diabetic Patients: Independent Association With Post-Breakfast Triglyceridemia.
abstract: BACKGROUND
  Associations of whole blood viscosity (WBV) with metabolic syndrome (MS) have not been extensively studied in patients with type 2 diabetes.
  
  
  METHODS
  Intrapersonal means of 12 measurements of waist circumference, blood pressure (BP) and high-density lipoprotein cholesterol and those of six measurements of fasting and post-breakfast triglycerides (TG) during 12 months were calculated in a cohort of 168 patients with type 2 diabetes. Based on these means, MS was diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel III criteria with the Asian definition of abdominal obesity. WBV was calculated from hematocrit and total serum protein concentrations by a validated formula.
  
  
  RESULTS
  Diabetes patients with MS (n = 77) had higher WBV as compared to those without MS (6.38 ± 0.06 vs. 6.10 ± 0.07 cP, P = 0.004). As the number of MS components increased, WBV increased (component number 1: 6.12 ± 0.10, 2: 6.09 ± 0.10, 3: 6.37 ± 0.08, 4: 6.42 ± 0.10, 5: 6.30 ± 0.15 cP, P for trends = 0.001). Multiple regression analysis revealed that male gender, diastolic BP and post-breakfast TG were determinants of WBV independent of fasting TG, body mass index (BMI) and waist circumference (R2= 0.258).
  
  
  CONCLUSIONS
  Both the presence of MS and the number of MS components were associated with higher WBV in patients with type 2 diabetes. Physicians need to perform a close follow-up of type 2 diabetes patients with MS on inhibitors of sodium-glucose co-transporters 2, which may increase stroke risk associated with an increase in hematocrit and therefore blood viscosity. Post-breakfast TG was an independent determinant of WBV. Elevated WBV may represent an important confounder of the relationship between MS, postprandial hyperlipidemia and elevated cardiovascular risk in this population.
authors.affiliation: Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Graduate School of Human Science and Environment, University of Hyogo, Himeji, Hyogo, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Minato
authors.affiliation: Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Takenouchi
authors.affiliation: Postgraduate School of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Uchida
authors.affiliation: Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Department of Nutrition, Osaka City Juso Hospital, Osaka, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Tsuboi
authors.affiliation: Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Postgraduate School of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Kurata
authors.affiliation: Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Postgraduate School of Food Sciences and Nutrition, Mukogawa Women's University, Nishinomiya, Hyogo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Fukuo
authors.affiliation: Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan; Diabetes Division, Department of Medicine, Kohnan Kakogawa Hospital, Kakogawa, Hyogo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kazumi
keywords: Blood viscosity; Hematocrit; Metabolic syndrome; Postprandial TG; Type 2 diabetes