International Journal of Nutrition, Pharmacology, Neurological Diseases

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 8  |  Issue : 4  |  Page : 162--166

Effect of Body Mass Index, Smoking, and Aspirin Administration on Polycythemia Incidences


Adnan H Mahmood1, Maeda Y Naser2,  
1 Department of Nutrition, The Medical Technical Institute of Baghdad, The Middle Technical University, Baghdad, Iraq
2 Department of X-ray Techniques, The Medical Technical Institute of Baghdad, The Middle Technical University, Baghdad, Iraq

Correspondence Address:
Adnan H Mahmood
Department of Nutrition, The Medical Technical Institute of Baghdad, The Middle Technical University, Baghdad
Iraq

Abstract

Aims: Polycythemia is an increase in red cell mass as evidenced by increase in hemoglobin (Hb), hematocrit, and number of circulating erythrocytes. The aim of this study was to investigate the effect of some clinical manifestation on the occurrence of polycythemia including overweight, smoking, meat consumption, chronic diseases, previous history, family history, recurrent blood donation, and aspirin administration. Materials and Methods: This study was performed at The Iraqi National Blood Bank in Baghdad. Data including weight, height, and Hb levels were estimated personally from 80 patients attending on three different days at the bank for blood donation. Each of the patients were asked about having clinical manifestation tested in this study. Results: Hb levels were slightly elevated when body mass index values were increased. Approximately 61% of patients having high Hb levels were meat consumers compared to nonmeat consumers who did not have high Hb levels. About 36% of patients who had high Hb levels were smokers compared to 11% who were nonsmokers. A total of 17% of patients having high Hb levels were taking aspirin in comparison to 26% who were not taking this drug. Chronic diseases, family history, previous history, or recurrent donation seem to have unclear effect on Hb levels. Conclusion: Smoker and overweight people seemed to have higher Hb levels, whereas aspirin administration led to decreasing Hb levels. Other manifestation had little or no relationship with Hb levels.



How to cite this article:
Mahmood AH, Naser MY. Effect of Body Mass Index, Smoking, and Aspirin Administration on Polycythemia Incidences.Int J Nutr Pharmacol Neurol Dis 2018;8:162-166


How to cite this URL:
Mahmood AH, Naser MY. Effect of Body Mass Index, Smoking, and Aspirin Administration on Polycythemia Incidences. Int J Nutr Pharmacol Neurol Dis [serial online] 2018 [cited 2019 May 25 ];8:162-166
Available from: http://www.ijnpnd.com/text.asp?2018/8/4/162/248539


Full Text



 Introduction



As first described in 1892, polycythemia vera is a clonal disorder arising in morphologically normal red cells, white cells, platelets, and their progenitors in the absence of a definable stimulus and to the exclusion of nonclonal hematopoiesis.[1] While uncommon, with an incidence rate of at least 2 per 100,000 of population,[2] a higher incidence has been suggested in individuals of Jewish origin 44–48 and among parent-offspring pairs.[3] Median age at diagnosis of polycythemia is approximately 60 years with a slight (1.2:1) male majority. Approximately 7% of patients are detected below age 40 years, and children are rarely diagnosed with polycythemia.[3] After 10 decades of careful clinical and laboratory investigation, the etiology of polycythemia vera remains unknown, and there is no consensus as to the optimal therapy for the disorder.[4]

There are some factors or parameters affecting the occurrence of polycythemia. A significant proportion of patients with polycythemia are above their ideal body mass index (BMI).[5] Males are markedly predominated of apparent and relative polycythemia studies. Obesity could cause hypoventilation at night and in the recumbent position, which produce arterial hypoxemia. However, hypertension, more common in obese patients, is a relatively common finding in patients with apparent polycythemia.[6],[7],[8] Smokers have higher packed cell volume (PCV) values than nonsmokers. The principal effect of smoking is to reduce the arterial oxygen content by increasing the carbon monoxide content of the blood from the nonsmoker level of less than 2.5% to values up to 10% and occasionally more.[9],[10],[11]

To examine the effect of these factors on the presence of polycythemia in Iraq, this study aimed to define the effect of BMI, smoking, aspirin administration, and other parameters on hemoglobin (Hb) levels.

 Materials and Methods



Study design and patients

The study was performed at The Iraqi National Blood Bank in Baghdad in April 2016. Data including age, sex, living place, weight, and height were collected personally from 80 patients attending on three different days at the bank for blood donation. Patients were questioned about different parameters including smoking and having large amounts and/or frequent times of meat. All patients signed a consent form for participating in this study. In addition, chronic diseases and abnormal signs, having history of polycythemia in person and/or in family, and prevolunteering manifestation were also asked. Chronic diseases included hypertension, diabetes, sinusitis, and dyspnea. Patients were also asked about taking aspirin frequently.

Tested parameters

Hb values for each patient were estimated immediately after collecting at the bank by technicians using HemoCue Hb 301 Analyzer System (HemoCue AB, Kuvettgatan 1, Sweden). Patients who had Hb value of 17 g/dL and more were categorized as polycythemic patients.

BMI was calculated using the following equation:[INLINE:1]

where power = (height)2

Normal distribution of the sample was tested. All data were measured and statistically analyzed to be presented using the Microsoft Excel.

 Results



Thirty out of 80 patients had Hb levels more than 17 g/dL and considered to be polycythemic. According to Hb values, patients were found to be normally distributed with dominancy of high values [Figure 1]. Hb levels were slightly raised when BMI values increased, this indicates a positive relationship between Hb levels and BMI values [Figure 2].{Figure 1}{Figure 2}

[Table 1] shows numbers and percentages of high to nonhigh Hb levels for each parameter of manifestation (existence of remarked parameter), and high to nonhigh Hb levels of parameters with no manifestation. [Table 2] presented percentages of high Hb levels compared to low and normal Hb levels with or without existence of the same manifestation. About 61% of patients with high Hb levels were meat consumers compared to nonmeat consumers who had no high Hb levels. Approximately 36% of patients who had high Hb levels were smokers compared to 11% who were nonsmokers. In contrast, 17% of patients who were taking aspirin had high Hb levels in comparison to 28% who were not taking this drug.{Table 1}{Table 2}

All other parameters such as chronic diseases, family history, previous history, or recurrent donation seem to have little or unclear effect on Hb levels (see [Table 2]).

 Discussion



The study included 80 blood donors to examine the effect of some parameters including BMI, smoking, meat consumption, chronic diseases, family history and previous individual history, recurrent blood donation, and administration of aspirin. The sample size seems to be realistic to the population after been tested in [Figure 1].

The increase in BMI led to increase in Hb levels [Figure 2]; this might be consistent with the previous findings that the proportion of patients with polycythemia was significantly above their superlative BMI.[5],[12],[13] Obese or overweight people may have hypoxia more than others who have normal BMI.[14],[15] Tissue hypoxia is suggested as a cause of erythrocytosis.[1],[15]

The results indicated that smoking leads to increase of Hb levels as well as the findings of previous reports that stated smoking is considered a reason of reversible primary or secondary polycythemia.[9],[16] Secondary erythrocytosis was also manifested in a young male due to abuse of hookah (narghile) smoking.[17] However, laboratory results showed that Hb was 22.7 g/dL and haematocrit was 69.1%, whereas WBC differential count, and platelets count were within the normal limits.[17]

Consumption of meat might have significant effect on Hb levels (see [Figure 3] and [Figure 4] and [Table 1] and [Table 2]). In our study, it is difficult to confirm that eating of meat has an effect on Hb levels as only one person was nonmeat eater among tested patients. However, previous reports stated that red meat enhance heme-iron absorption leading to elevation of Hb and PCV levels,[18] whereas another study reported that meat consumption has no effect on Hb levels.[19]{Figure 3}{Figure 4}

Diseases and family history might have little or no effect on Hb levels; due to few manifestations of these parameters, further comprehensive studies will be needed to determine the impact if existed.Previous history and recurrent donation seem to have little or no effect on Hb levels (see [Figure 3] and [Figure 4] and [Table 2]). Prior studies found that repeated blood donations (more than three times a year) might reduce iron level, which consequently leads to boost blood genesis.[20]

Aspirin in this study seems to have an impact on decreasing Hb levels as seen in the results. Interestingly, no data are provided to approve or describe this finding. Previous studies have only reported that aspirin as an antithrombotic agent decreased the risk of thrombosis in polycythemic patients[21],[22],[23],[24],[25] with no indication whether it is affecting Hb levels or not. Therefore, further studies will be needed to confirm its effect on Hb levels.

The interaction effects among different manifestation were not examined in this study; additional studies will be required to investigate these interferences.

 Conclusion



This study was performed to exhibit the effect of some clinical manifestations on the occurrence of polycythemia. Overweight and smoking may lead to elevating Hb levels, whereas aspirin administration led to reducing its levels. Previous history and recurrent donation seemed to have little effect. Meat consumption, chronic diseases, and family history had unclear effect on Hb levels; therefore, further studies will be needed to determine this effect.

Volunteers who undertake (repeated) blood donation should receive special nutritional care, especially in terms of iron and energy supplements. Additional studies are needed to investigate cross-effect interactions of clinical manifestations above on Hb levels.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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