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American Journal of Epidemiology Advance Access published online on October 17, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn243
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American Journal of Epidemiology © 2008 The Authors
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Original Contribution

Blood Viscosity and Hematocrit as Risk Factors for Type 2 Diabetes Mellitus

The Atherosclerosis Risk in Communities (ARIC) Study

Leonardo J. Tamariz, J. Hunter Young, James S. Pankow, Hsin-Chieh Yeh, Maria Ines Schmidt, Brad Astor and Frederick L. Brancati

Correspondence to Dr. J. Hunter Young, Departments of Medicine and Epidemiology, The Johns Hopkins University, 2024 East Monument Street, Suite 2-625, Baltimore, MD 21287 (e-mail: jhyoung{at}jhmi.edu).

Received for publication November 14, 2007. Accepted for publication July 14, 2008.

Several lines of evidence support the notion that elevated blood viscosity may predispose to insulin resistance and type 2 diabetes mellitus by limiting delivery of glucose, insulin, and oxygen to metabolically active tissues. To test this hypothesis, the authors analyzed longitudinal data on 12,881 initially nondiabetic adults, aged 45–64 years, who were participants in the Atherosclerosis Risk in Communities (ARIC) Study (1987–1998). Whole blood viscosity was estimated by using a validated formula based on hematocrit and total plasma proteins at baseline. At baseline, estimated blood viscosity was independently associated with several features of the metabolic syndrome. In models adjusted simultaneously for known predictors of diabetes, estimated whole blood viscosity and hematocrit predicted incident type 2 diabetes mellitus in a graded fashion (Ptrend (linear) < 0.001): Compared with their counterparts in the lowest quartiles, adults in the highest quartile of blood viscosity (hazard ratio = 1.68, 95% confidence interval: 1.53, 1.84) and hematocrit (hazard ratio = 1.63, 95% confidence interval: 1.49, 1.79) were over 60% more likely to develop diabetes. Therefore, elevated blood viscosity and hematocrit deserve attention as emerging risk factors for insulin resistance and type 2 diabetes mellitus.

blood viscosity; diabetes mellitus, type 2; hematocrit; insulin resistance; metabolic syndrome X; oxidative phosphorylation

Abbreviations: ARIC, Atherosclerosis Risk in Communities; CI, confidence interval; FEV1, forced expiratory volume at 1 second; RH, relative hazard


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