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However, data on the association of Hb levels with subclinical atherosclerosis beyond metabolic abnormalities are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study evaluated the association among serum Hb level, metabolic syndrome (MetS), and the risk of carotid plaque formation in asymptomatic adults without a history of major adverse clinical events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2560 participants (mean age: 60\u2009\u00b1\u20098\u00a0years, 32.9% men) were stratified into four groups based on Hb quartiles, as follows: \u2264\u200912.8\u00a0g\/dL (group I), 12.9\u201313.6\u00a0g\/dL (group II), 13.7\u201314.5\u00a0g\/dL (group III), and \u2265\u200914.6\u00a0g\/dL (group IV). The overall prevalence of MetS and carotid plaque was 37.2% and 33.4%, respectively. The prevalence of MetS increased with increasing Hb level (group I: 27.4% vs. group II: 35.9% vs. group III: 42.6% vs. group IV: 44.1%,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The prevalence of carotid plaque was 34.3%, 28.1%, 32.8%, and 39.5% in groups I, II, III, and IV, respectively. Univariate logistic regression analysis showed that MetS was associated with an increased risk of carotid plaque (odds ratio [OR] 1.568, 95% confidence interval [CI] 1.326\u20131.856,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Only group II showed a lower risk of carotid plaque than group I (OR 0.750, 95% CI 0.596\u20130.943,<jats:italic>p<\/jats:italic>\u2009=\u20090.014). Multiple logistic regression models showed consistent results after adjusting for clinical factors, including MetS and its individual components.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serum Hb level is associated with the risk of carotid plaque beyond MetS and its components in a relatively healthy adult population.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12872-021-01852-7","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:04:09Z","timestamp":1614643449000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of serum hemoglobin level with the risk of carotid plaque beyond metabolic abnormalities among asymptomatic adults without major adverse clinical events: a cross-sectional cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"Yunsuk","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ki-Bum","family":"Won","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5860-9407","authenticated-orcid":false,"given":"Hyeon Hui","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyuk-Jae","family":"Change","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"1852_CR1","doi-asserted-by":"publisher","first-page":"2042","DOI":"10.1161\/01.CIR.0000162477.70955.5F","volume":"111","author":"MS Sabatine","year":"2005","unstructured":"Sabatine MS, Morrow DA, Giugliano RP, et al. 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