Increased erythropoiesis and subclinical inﬂammation as part of the metabolic syndrome T. Mardi a,d,e , S. Toker a,b,d,e , S. Melamed c,d,e , A. Shirom b,e , D. Zeltser a,d,e , I. Shapira a,d,e , S. Berliner a,d,e, * , O. Rogowski a,d,e a Department of Medicine ‘‘D’’ and Institute for Special Medical Examinations (MALRAM), Tel Aviv Sourasky Medical Center, Tel Aviv, afﬁliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6 Weizman Street, Tel Aviv 64239, Israel b Faculty of Management, Tel Aviv University, Tel Aviv, Israel c National Institute of Occupational and Environmental Health, Raanana, Israel d Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel e Tel Aviv Medical Center Inﬂammation Survey (TAMCIS) Group, Tel Aviv, Israel Received 7 June 2004; received in revised form 25 November 2004; accepted 10 January 2005 Available online 3 March 2005 Abstract Recent studies have suggested the insulin resistance might be accompanied by enhanced erythropoiesis. We have examined this association in individuals with the metabolic syndrome (MS) who in addition to insulin resistance harbor a chronic low grade inﬂammation. This study is relevant because chronic inﬂammation might have a suppressive effect on erythropoiesis. 280 and 554 non-smoking women and men with respective age of 46.4  9.3 (mean  S.D.) and 44.0  11.0 years are included. A signiﬁcant correlation was noted between the numbers of the components of the MS and the inﬂammatory biomarkers including the white blood cell count, high sensitivity C-reactive protein, ﬁbrinogen concentrations and the erythrocyte sedimentation rate. In addition, a signiﬁcant correlation (r = 0.157, p = 0.008) was noted between the number of components of the MS and the number of red blood cells in the peripheral blood in women. The same was true for men (r = 0.192, p < 0.0005). We conclude that enhanced erythropoiesis could be a new, hitherto unrecognized component of the MS. The enhanced erythropoiesis could give an erroneous impression of general ‘‘good’’ health in these individuals. # 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Erythropoiesis; Metabolic syndrome; Inﬂammation www.elsevier.com/locate/diabres Diabetes Research and Clinical Practice 69 (2005) 249–255 Abbreviations: MS, metabolic syndrome; TAMCIS, Tel Aviv Medical Center Inﬂammation Survey; WBCC, white blood cell count; ESR, erythrocyte sedimentation rate; hs-CRP, high sensitivity C-reactive protein; HOMA, homeostasis model assessment; BMI, body mass index; RBC, red blood cells; PMN, polymorphonuclears; BP, blood pressure * Corresponding author. Tel.: +972 3 6973133; fax: +972 3 6974961. E-mail address: shapiraiz@tasmc.health.gov.il (S. Berliner). 0168-8227/$ – see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2005.01.005