Pseudo polycythaemia and its association with cardio-metabolic risk factors: A preliminary descriptive analysis from a tertiary care hospital

Abstract

INTRODUCTION AND OBJECTIVES: Polycythaemia is the result of either an actual increase in red cell mass (true) or relative reduction in plasma volume (spurious). Spurious or pseudo-polycythaemia (PP) is a poorly-researched entity with unexplained increase in mortality noted in previous studies. We aimed to characterize PP and determine an association between PP and metabolic syndrome (MS) in a Sri Lankan clinic-based population. METHODS: Consecutive, consenting adults > 18 years, with two consecutive haemoglobin levels> l 6.5mg/dL and > 16mg/dL and/or PCV >49% and >48% in men and women respectively, with non-tourniquet samples taken few days apart in a well-hydrated state, were recruited from clinics of University Medical Unit, Colombo North Teaching Hospital and from the private sector. Interviewer-administered questionnaire was used to gather data.RESULTS: 46 participants were recruited: 3 (6.5%) had primary polycythemia, 5 (10.9%) had secondary polycythemia due to identifiable causes. 38 (82.6%) patients had PP [mean age 42.2 (SD=l5.2) years and 36 (94.7%) were males]. Of these 14 (36.8%) had diabetes, 22 (57.9%) had hypertension, 25 (65.8%) had hyperlipidemia and 25 (65.8%) were obese. 19 (50%) had fatty liver, 23 (60.5%) were light smokers, 8 (21.1%) consumed alcohol beyond safe limits, 6 (15.8%) had increased neck circumference, 1 (2.6%) had ischemic heart disease, 2 (5.3%) had chronic kidney disease and 2 (5.3%) had hyperuricaemia. Comparison of PP and secondary polycythemia with regard to prevalent components of MS was not possible due to small numbers.CONCLUSION: Components of MS were prevalent among those with PP. The significance of this finding remains unexplained. This needs to be replicated in a larger sample to establish whether these are independent risk factors for the development of PP.