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Association of hemoglobin with ankle-brachial index in general population
Zhang Chenglong1, Lei Jing1, Ke Xia1
1Central South University, Xiangya Hospital, Department of Cardiology, Changsha, Hunan/China.
Insights
High hemoglobin levels in men were linked to a lower ankle-brachial index, suggesting increased atherosclerosis risk. This finding highlights hemoglobin
Area of Science:
- Cardiovascular Medicine
- Hematology
- Vascular Biology
Background:
- Hemoglobin concentration is linked to cardiovascular outcomes.
- Ankle-brachial index (ABI) screens for peripheral arterial disease.
- The relationship between hemoglobin and ABI is not well-established.
Purpose of the Study:
- To investigate the association between hemoglobin levels and ABI.
- To identify determinants of ABI in a healthy population.
- To explore potential links to atherosclerosis risk.
Main Methods:
- Examined 786 healthy adults (236 women, 550 men).
- Collected data on ABI, hemoglobin, hematocrit, red blood cell count, and other factors.
- Utilized univariate/multivariate linear regression and ROC curve analysis.
Main Results:
- Hemoglobin, hematocrit, and RBC count correlated with ABI in males, but not females.
- In males, age, hypertension, total cholesterol, and hemoglobin were independent ABI determinants.
- A hemoglobin cut-off of 156.5 g/L predicted low ABI in males.
Conclusions:
- Elevated hemoglobin is independently associated with a lower ABI in healthy males.
- High hemoglobin may indicate increased atherosclerosis risk in men.
- Further research is needed to confirm these findings and their clinical implications.
Objectives:
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.
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Prepare for the Procedure:
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.