{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:20:37Z","timestamp":1790234437837,"version":"4.1.0"},"reference-count":89,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007861","name":"University of Gondar","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007861","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Metabolic Syndrome (MetS) is a cluster of interconnected metabolic diseases. Hematological abnormalities are common but neglected complications of MetS. Thus, this study aimed to determine the magnitude of hematological abnormalities and their associated factors among MetS patients at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>A hospital-based cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital from March to May 2022. A total of 384 MetS patients were selected using a systematic random sampling technique. Data were collected using pre-tested structured questionnaires and checklists. Anthropometric and blood pressure measurements were taken, and blood sample was collected for complete blood count determination. Stool and blood film examinations were performed to detect intestinal and malaria parasites, respectively. Data were entered into EpiData 3.1 and analyzed by Stata 14.0 software. Bivariate and multivariate logistic regression models were fitted to identify factors associated with hematological abnormalities. A p-value of &lt; 0.05 was considered statistically significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The magnitude of anemia, leukopenia, leukocytosis, thrombocytopenia, and thrombocytosis was found to be 13.3%, 0.5%, 2.9%, 1.6%, and 2.3%, respectively. Being male (AOR = 2.65, 95% CI: 1.14, 6.20), rural residency (AOR = 5.79, 95% CI: 1.72, 19.51), taking antihypertensive medications (AOR = 3.85, 95% CI: 1.16, 12.78), having elevated triglyceride level (AOR = 2.21, 95% CI: 1.03, 4.75), and being overweight or obese (AOR = 0.32, 95% CI: 0.16, 0.64) were significantly associated with anemia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Anemia was the most prevalent hematological abnormality identified in the present study, followed by leukocytosis and thrombocytosis. Anemia was a mild public health problem among MetS patients in the study area. Routine anemia screening for all MetS patients, especially for those with significant associated factors, may help in the early detection and effective management of anemia, which subsequently improves the patients\u2019 quality of life.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0286163","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T17:42:23Z","timestamp":1685036543000},"page":"e0286163","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hematological abnormalities and associated factors among metabolic syndrome patients at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-0171","authenticated-orcid":true,"given":"Amanuel","family":"Kelem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Shiferaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6597-5755","authenticated-orcid":true,"given":"Tiruneh","family":"Adane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"issue":"3","key":"pone.0286163.ref001","doi-asserted-by":"crossref","first-page":"189","DOI":"10.5223\/pghn.2020.23.3.189","article-title":"Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome","volume":"23","author":"HH Wang","year":"2020","journal-title":"Pediatric gastroenterology, hepatology & nutrition"},{"issue":"25","key":"pone.0286163.ref002","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1161\/circ.106.25.3143","article-title":"Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report","volume":"106","year":"2002","journal-title":"Circulation"},{"issue":"3","key":"pone.0286163.ref003","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1161\/01.CIR.0000111245.75752.C6","article-title":"Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute\/American Heart Association conference on scientific issues related to definition","volume":"109","author":"SM Grundy","year":"2004","journal-title":"Circulation"},{"issue":"5","key":"pone.0286163.ref004","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic syndrome\u2014a new world-wide definition. A Consensus Statement from the International Diabetes Federation","volume":"23","author":"KG Alberti","year":"2006","journal-title":"Diabetic medicine: a journal of the British Diabetic Association"},{"issue":"16","key":"pone.0286163.ref005","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"KG Alberti","year":"2009","journal-title":"Circulation"},{"key":"pone.0286163.ref006","doi-asserted-by":"crossref","unstructured":"Beck-Nielsen H. The Metabolic Syndrome: Pharmacology and Clinical Aspects. New York Springer-Verlag Wien; 2013 [cited 2022 January 30]. Available from: https:\/\/et1lib.org\/book\/2202681\/a0fcdc.","DOI":"10.1007\/978-3-7091-1331-8"},{"key":"pone.0286163.ref007","doi-asserted-by":"crossref","first-page":"100135","DOI":"10.1016\/j.metop.2021.100135","article-title":"Prevalence of metabolic syndrome, its risk factors and associated lifestyles in Myanmar adult people: A community based cross-sectional study","volume":"12","author":"SS Maw","year":"2021","journal-title":"Metabolism open"},{"issue":"1","key":"pone.0286163.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ecl.2013.09.009","article-title":"Metabolic syndrome","volume":"43","author":"SL Samson","year":"2014","journal-title":"Endocrinology and metabolism clinics of North America"},{"issue":"2","key":"pone.0286163.ref009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11906-018-0812-z","article-title":"The Global Epidemic of the Metabolic Syndrome","volume":"20","author":"MG Saklayen","year":"2018","journal-title":"Curr Hypertens Rep"},{"issue":"1","key":"pone.0286163.ref010","first-page":"2033","article-title":"Prevalences of metabolic syndrome and its sex-specific association with socioeconomic status in rural China: a cross-sectional study","volume":"21","author":"X Ying","year":"2021","journal-title":"Metabolic syndrome and related disorders"},{"issue":"1","key":"pone.0286163.ref011","doi-asserted-by":"crossref","first-page":"8132","DOI":"10.1038\/s41598-021-87248-1","article-title":"Prevalence of metabolic syndrome and its associated risk factors among staffs in a Malaysian public university","volume":"11","author":"MRA Manaf","year":"2021","journal-title":"Scientific reports"},{"key":"pone.0286163.ref012","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/2701309","article-title":"The prevalence of metabolic syndrome in ethiopian population: a systematic review and meta-analysis","volume":"2020","author":"S Ambachew","year":"2020","journal-title":"Journal of obesity"},{"issue":"10","key":"pone.0286163.ref013","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0257306","article-title":"Magnitude of metabolic syndrome in Gondar town, Northwest Ethiopia: A community-based cross-sectional study","volume":"16","author":"SM Abebe","year":"2021","journal-title":"PloS one"},{"issue":"12","key":"pone.0286163.ref014","article-title":"Anemia and associated factors among type-2 diabetes mellitus patients attending public hospitals in Harari Region","volume":"14","author":"A Bekele","year":"2019","journal-title":"Eastern Ethiopia"},{"issue":"2","key":"pone.0286163.ref015","doi-asserted-by":"crossref","first-page":"114","DOI":"10.4103\/JMISR.JMISR_29_19","article-title":"Prevalence of anemia in patients with type 2 diabetes","volume":"2","author":"E-S Shaheen","year":"2019","journal-title":"Journal of Medicine in Scientific Research"},{"key":"pone.0286163.ref016","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12882-016-0247-1","article-title":"Anemia in type 2 diabetic patients and correlation with kidney function in a tertiary care sub-Saharan African hospital: a cross-sectional study","volume":"17","author":"VF Feteh","year":"2016","journal-title":"BMC nephrology"},{"key":"pone.0286163.ref017","first-page":"1","article-title":"Anemia in patients with diabetes mellitus: prevalence and progression","author":"M. Al-Salman","year":"2015","journal-title":"General Medicine: Open Access"},{"issue":"03","key":"pone.0286163.ref018","first-page":"435","article-title":"Prevalence of anemia types among overweight and obese patients attending the obesity research and therapy unit at AL-kindy college of medicine","volume":"24","author":"Z Al-Attar","year":"2020","journal-title":"Prevalence"},{"issue":"4","key":"pone.0286163.ref019","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0266089","article-title":"Anemia and associated factors among patients admitted with metabolic syndromes at Worabe Comprehensive Specialized Hospital, Southern Ethiopia: A cross-sectional study","volume":"17","author":"A Timerga","year":"2022","journal-title":"PloS one"},{"issue":"1","key":"pone.0286163.ref020","first-page":"49","article-title":"Anaemia in type 2 diabetes mellitus (T2DM) patients in Hospital Putrajaya","volume":"11","author":"SC Thambiah","year":"2015","journal-title":"Malaysian Journal of Medicine and Health Sciences"},{"issue":"6","key":"pone.0286163.ref021","doi-asserted-by":"crossref","first-page":"367","DOI":"10.21474\/IJAR01\/4421","article-title":"Anemia in type 2 diabetes patients with and without nephropathy in Anand-Gujarat, India","volume":"5","author":"H Abdulrahman","year":"2017","journal-title":"International Journal of Advanced Research"},{"issue":"1","key":"pone.0286163.ref022","first-page":"59","article-title":"White blood cell count and clustered components of metabolic syndrome: A study in western Iran","volume":"12","author":"MT Hedayati","year":"2021","journal-title":"Caspian journal of internal medicine"},{"issue":"2","key":"pone.0286163.ref023","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s12020-020-02243-2","article-title":"Leukocyte-related parameters in older adults with metabolic syndrome","volume":"68","author":"XJ Yang","year":"2020","journal-title":"Endocrine"},{"issue":"7","key":"pone.0286163.ref024","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1530\/EC-20-0209","article-title":"Platelet parameters in Chinese older adults with metabolic syndrome","volume":"9","author":"XJ Yang","year":"2020","journal-title":"Endocrine connections"},{"issue":"1","key":"pone.0286163.ref025","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/tropej\/fmt078","article-title":"Pediatric metabolic syndrome and cell blood counts: bivariate Bayesian modeling","volume":"60","author":"M Mansourian","year":"2014","journal-title":"Journal of tropical pediatrics"},{"issue":"11","key":"pone.0286163.ref026","doi-asserted-by":"crossref","first-page":"e49875","DOI":"10.1371\/journal.pone.0049875","article-title":"Association between leukocyte and metabolic syndrome in urban Han Chinese: a longitudinal cohort study","volume":"7","author":"W Meng","year":"2012","journal-title":"PloS one"},{"key":"pone.0286163.ref027","doi-asserted-by":"crossref","first-page":"583320","DOI":"10.3389\/fcvm.2021.583320","article-title":"Lymphocyte to High-Density Lipoprotein Ratio but Not Platelet to Lymphocyte Ratio Effectively Predicts Metabolic Syndrome Among Subjects From Rural China","volume":"8","author":"S Yu","year":"2021","journal-title":"Frontiers in cardiovascular medicine"},{"issue":"8","key":"pone.0286163.ref028","doi-asserted-by":"crossref","first-page":"758","DOI":"10.3109\/09537104.2014.995613","article-title":"The association between platelet count and metabolic syndrome in children and adolescents","volume":"26","author":"HJ Lim","year":"2015","journal-title":"Platelets"},{"issue":"4","key":"pone.0286163.ref029","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1038\/nrendo.2009.17","article-title":"Erythropoietic stress and anemia in diabetes mellitus","volume":"5","author":"DK Singh","year":"2009","journal-title":"Nature reviews Endocrinology"},{"issue":"1","key":"pone.0286163.ref030","first-page":"276","article-title":"Anemia of inflammation","volume":"2010","author":"CN Roy","year":"2010","journal-title":"Hematology 2010, the American Society of Hematology Education Program Book"},{"key":"pone.0286163.ref031","volume":"2021","author":"M Kohsari","year":"2021","journal-title":"Association between RBC Indices, Anemia, and Obesity-Related Diseases Affected by Body Mass Index in Iranian Kurdish Population: Results from a Cohort Study in Western Iran"},{"issue":"5","key":"pone.0286163.ref032","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1111\/febs.14606","article-title":"Oxidative stress, eryptosis and anemia: a pivotal mechanistic nexus in systemic diseases","volume":"286","author":"R Bissinger","year":"2019","journal-title":"The FEBS journal"},{"issue":"21\u201322","key":"pone.0286163.ref033","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.lfs.2009.02.026","article-title":"Oxidative stress and metabolic syndrome","volume":"84","author":"CK Roberts","year":"2009","journal-title":"Life sciences"},{"issue":"6","key":"pone.0286163.ref034","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/S1056-8727(04)00003-0","article-title":"Association between hematological parameters and metabolic syndrome components in a Chinese population","volume":"18","author":"YY Wang","year":"2004","journal-title":"Journal of diabetes and its complications"},{"issue":"3","key":"pone.0286163.ref035","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jacc.2004.10.038","article-title":"Angiotensin-converting enzyme inhibitor as a risk factor for the development of anemia, and the impact of incident anemia on mortality in patients with left ventricular dysfunction","volume":"45","author":"A Ishani","year":"2005","journal-title":"Journal of the American College of Cardiology"},{"issue":"9","key":"pone.0286163.ref036","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/j.1524-6175.2007.06296.x","article-title":"Antihypertensive medications and anemia","volume":"9","author":"DA Sica","year":"2007","journal-title":"Journal of clinical hypertension (Greenwich, Conn)"},{"issue":"3","key":"pone.0286163.ref037","first-page":"165","article-title":"Diabetes mellitus and metformin: fatal vitamin B12 deficiency associated with anemia and sepsis in a young adult","volume":"8","author":"A Katroth","year":"2018","journal-title":"Journal of Applied Pharmaceutical Science"},{"issue":"1","key":"pone.0286163.ref038","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.dsx.2018.12.016","article-title":"Relationship of leukocytes, platelet indices and adipocytokines in metabolic syndrome patients","volume":"13","author":"A Abdel-Moneim","year":"2019","journal-title":"Diabetes & metabolic syndrome"},{"issue":"1","key":"pone.0286163.ref039","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0735-1097(02)01938-1","article-title":"Anemia as a risk factor for cardiovascular disease in The Atherosclerosis Risk in Communities (ARIC) study","volume":"40","author":"MJ Sarnak","year":"2002","journal-title":"Journal of the American College of Cardiology"},{"issue":"6","key":"pone.0286163.ref040","first-page":"60","article-title":"Indian College of Physicians Position Statement on Anemia in Metabolic Syndrome","volume":"65","author":"M Sahay","year":"2017","journal-title":"The Journal of the Association of Physicians of India"},{"key":"pone.0286163.ref041","doi-asserted-by":"crossref","first-page":"294","DOI":"10.3389\/fendo.2020.00294","article-title":"Obesity-Induced Changes in Bone Marrow Homeostasis","volume":"11","author":"A Benova","year":"2020","journal-title":"Frontiers in endocrinology"},{"issue":"8","key":"pone.0286163.ref042","doi-asserted-by":"crossref","first-page":"949","DOI":"10.5966\/sctm.2014-0052","article-title":"Concise review: diabetes, the bone marrow niche, and impaired vascular regeneration","volume":"3","author":"GP Fadini","year":"2014","journal-title":"Stem Cells Transl Med"},{"issue":"12","key":"pone.0286163.ref043","doi-asserted-by":"crossref","first-page":"e4290","DOI":"10.1210\/clinem\/dgaa516","article-title":"Bone Marrow Metabolism Is Impaired in Insulin Resistance and Improves After Exercise Training","volume":"105","author":"R Ojala","year":"2020","journal-title":"The Journal of clinical endocrinology and metabolism"},{"issue":"1","key":"pone.0286163.ref044","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1590\/S0004-27302006000100016","article-title":"Relation between insulin resistance and hematological parameters in a Brazilian sample","volume":"50","author":"VC Ellinger","year":"2006","journal-title":"Arquivos brasileiros de endocrinologia e metabologia"},{"key":"pone.0286163.ref045","first-page":"1","volume-title":"Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity","author":"World Health Organization","year":"2011"},{"issue":"2","key":"pone.0286163.ref046","first-page":"135","article-title":"To evaluate the renal function deterioration along with other anemia predictors in patients with diabetes mellitus type 2 in Karachi, Pakistan","volume":"33","author":"K Ahmed","year":"2017","journal-title":"Pak J Surg"},{"issue":"7","key":"pone.0286163.ref047","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1111\/tmi.13071","article-title":"Haematological and immunological reference intervals for adult population in the state of Amhara, Ethiopia","volume":"23","author":"B Enawgaw","year":"2018","journal-title":"Tropical medicine & international health: TM & IH"},{"key":"pone.0286163.ref048","unstructured":"World Health Organization. WHO STEPS surveillance manual. The WHO STEPwise approach to noncommunicable disease risk factor surveillance (STEPS)[Google Scholar]. Geneva: WHO 2017. p. 179\u201389."},{"issue":"6","key":"pone.0286163.ref049","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0253286","article-title":"Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross-sectional study","volume":"16","author":"M Arkew","year":"2021","journal-title":"PloS one"},{"key":"pone.0286163.ref050","first-page":"467","volume":"14","author":"T Tujuba","year":"2021","journal-title":"Anemia among Adult Diabetic Patients Attending a General Hospital in Eastern Ethiopia: a Cross-sectional Study"},{"issue":"58","key":"pone.0286163.ref051","first-page":"91","article-title":"Anemia and diabetic retinopathy in type 2 diabetes mellitus","volume":"58","author":"PK Ranil","year":"2010","journal-title":"The Journal of the Association of Physicians of India"},{"issue":"8","key":"pone.0286163.ref052","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/j.1464-5491.2006.01893.x","article-title":"Prevalence and associations of low plasma erythropoietin in patients with Type 2 diabetes mellitus","volume":"23","author":"OA Mojiminiyi","year":"2006","journal-title":"Diabetic medicine: a journal of the British Diabetic Association"},{"issue":"4","key":"pone.0286163.ref053","doi-asserted-by":"crossref","first-page":"e19976","DOI":"10.5812\/numonthly.19976","article-title":"Anemia and microvascular complications in patients with type 2 diabetes mellitus","volume":"6","author":"MS Hosseini","year":"2014","journal-title":"Nephro-urology monthly"},{"issue":"12","key":"pone.0286163.ref054","doi-asserted-by":"crossref","first-page":"e025125","DOI":"10.1136\/bmjopen-2018-025125","article-title":"Anaemia among primary care patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD): a multicentred cross-sectional study","volume":"8","author":"I Idris","year":"2018","journal-title":"BMJ open"},{"key":"pone.0286163.ref055","first-page":"1070","article-title":"Study of hematological profile of anemia in type 2 diabetes mellitus patients","volume":"5","author":"B Puneeth","year":"2017","journal-title":"Sch J Appl Med Sci"},{"key":"pone.0286163.ref056","doi-asserted-by":"crossref","first-page":"354737","DOI":"10.1155\/2015\/354737","article-title":"Anemia in Patients with Type 2 Diabetes Mellitus","volume":"2015","author":"J Barbieri","year":"2015","journal-title":"Anemia"},{"issue":"5","key":"pone.0286163.ref057","first-page":"277","article-title":"Relationship between Anemia and Chronic Complications in Chinese Patients with Type 2 Diabetes Mellitus","volume":"18","author":"BB He","year":"2015","journal-title":"Arch Iran Med"},{"key":"pone.0286163.ref058","first-page":"47","article-title":"Anemia and Its Associated Factors Among Type 2 Diabetes Mellitus Patients Attending Debre Berhan Referral Hospital, North-East Ethiopia: A Cross-Sectional Study","volume":"11","author":"MM Taderegew","year":"2020","journal-title":"PloS one"},{"key":"pone.0286163.ref059","doi-asserted-by":"crossref","first-page":"6627979","DOI":"10.1155\/2021\/6627979","article-title":"Prevalence of Anaemia and Its Associated Factors among Type 2 Diabetes Mellitus Patients in University of Gondar Comprehensive Specialized Hospital","volume":"2021","author":"SA Kebede","year":"2021","journal-title":"Anemia"},{"issue":"3","key":"pone.0286163.ref060","first-page":"214","article-title":"Anaemia and type 2 diabetes: implications from a retrospectively studied primary care case series","volume":"19","author":"CX Chen","year":"2013","journal-title":"Hong Kong medical journal = Xianggang yi xue za zhi"},{"issue":"5","key":"pone.0286163.ref061","article-title":"Risk factors for incident anemia of chronic diseases: A cohort study","volume":"14","author":"YG Lee","year":"2019","journal-title":"PloS one"},{"issue":"2\u20133","key":"pone.0286163.ref062","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1159\/000356535","article-title":"Chronic low-grade inflammation in metabolic disorders: relevance for behavioral symptoms","volume":"21","author":"J Lasselin","year":"2014","journal-title":"Neuroimmunomodulation"},{"issue":"4","key":"pone.0286163.ref063","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/j.1523-1755.2005.00226.x","article-title":"Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program","volume":"67","author":"TM El-Achkar","year":"2005","journal-title":"Kidney international"},{"key":"pone.0286163.ref064","article-title":"Prevalence and risk of anemia in type-2 diabetic patients","volume":"2014","author":"A Sharif","year":"2014","journal-title":"Health"},{"key":"pone.0286163.ref065","first-page":"14","article-title":"Study of hematological profile and its significance in type 2 diabetes mellitus patients","volume":"1","author":"K. Bharathi","year":"2016","journal-title":"J Diagn Pathol Oncol"},{"key":"pone.0286163.ref066","first-page":"89","volume":"11","author":"TS Tesfaye","year":"2020","journal-title":"Prevalence of Anemia and Associated Factors Among \"Apparently Healthy\" Urban and Rural Residents in Ethiopia: A Comparative Cross-Sectional Study"},{"issue":"1","key":"pone.0286163.ref067","article-title":"Heme iron in meat as the main source of iron in the human diet","volume":"21","author":"M Buzala","year":"2016","journal-title":"Journal of Elementology"},{"issue":"6","key":"pone.0286163.ref068","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1024\/0300-9831.74.6.403","article-title":"Enhancers of iron absorption: ascorbic acid and other organic acids","volume":"74","author":"B Teucher","year":"2004","journal-title":"International journal for vitamin and nutrition research Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung Journal international de vitaminologie et de nutrition"},{"issue":"10","key":"pone.0286163.ref069","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1038\/oby.2008.353","article-title":"Is obesity associated with anemia of chronic disease? A population-based study","volume":"16","author":"KJ Ausk","year":"2008","journal-title":"Obesity (Silver Spring, Md)"},{"issue":"12","key":"pone.0286163.ref070","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1373\/clinchem.2005.058644","article-title":"Increased lipid concentration is associated with increased hemolysis","volume":"51","author":"G Dimeski","year":"2005","journal-title":"Clinical chemistry"},{"issue":"8","key":"pone.0286163.ref071","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1080\/00325481.2016.1243980","article-title":"Correlation of the leucocyte count with traditional and non-traditional components of metabolic syndrome","volume":"128","author":"BY Su","year":"2016","journal-title":"Postgraduate medicine"},{"issue":"2","key":"pone.0286163.ref072","first-page":"90","article-title":"Hematologic parameters as the predictors for metabolic syndrome in perimenopausal and postmenopausal women living in urban area: a preliminary report","volume":"15","author":"R Naffa","year":"2016","journal-title":"Therapeutic advances in endocrinology and metabolism"},{"issue":"2","key":"pone.0286163.ref073","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1089\/met.2012.0179","article-title":"Increased neutrophil count in nascent metabolic syndrome","volume":"11","author":"H Kaur","year":"2013","journal-title":"Metabolic syndrome and related disorders"},{"issue":"6","key":"pone.0286163.ref074","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s00592-012-0402-5","article-title":"Elevated white blood cell count is associated with prevalence and development of the metabolic syndrome and its components in the general population","volume":"49","author":"GP Fadini","year":"2012","journal-title":"Acta diabetologica"},{"issue":"3","key":"pone.0286163.ref075","doi-asserted-by":"crossref","first-page":"e58354","DOI":"10.1371\/journal.pone.0058354","article-title":"White blood cell counts as risk markers of developing metabolic syndrome and its components in the PREDIMED study","volume":"8","author":"N Babio","year":"2013","journal-title":"PloS one"},{"issue":"3","key":"pone.0286163.ref076","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.ecl.2008.05.001","article-title":"Insulin resistance and atherosclerosis","volume":"37","author":"B Razani","year":"2008","journal-title":"Endocrinology and metabolism clinics of North America"},{"issue":"5","key":"pone.0286163.ref077","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.2337\/diacare.26.5.1362","article-title":"Insulin resistance, inflammation, and serum fatty acid composition","volume":"26","author":"JM Fern\u00e1ndez-Real","year":"2003","journal-title":"Diabetes care"},{"issue":"5","key":"pone.0286163.ref078","doi-asserted-by":"crossref","first-page":"e19871","DOI":"10.1371\/journal.pone.0019871","article-title":"Adipose inflammation initiates recruitment of leukocytes to mouse femoral artery: role of adipo-vascular axis in chronic inflammation","volume":"6","author":"S Hagita","year":"2011","journal-title":"PloS one"},{"issue":"3","key":"pone.0286163.ref079","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.diabres.2006.02.001","article-title":"The association of total and differential white blood cell count with metabolic syndrome in type 2 diabetic patients","volume":"73","author":"WS Shim","year":"2006","journal-title":"Diabetes research and clinical practice"},{"issue":"3","key":"pone.0286163.ref080","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jcma.2016.07.003","article-title":"Higher platelet counts are associated with metabolic syndrome independent of fatty liver diagnosis","volume":"80","author":"KC Fang","year":"2017","journal-title":"Journal of the Chinese Medical Association: JCMA"},{"issue":"1","key":"pone.0286163.ref081","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.dsx.2017.07.044","article-title":"The association between hematological parameters and metabolic syndrome in Iranian men: A single center large-scale study","volume":"12","author":"J Ahmadzadeh","year":"2018","journal-title":"Diabetes & metabolic syndrome"},{"issue":"1","key":"pone.0286163.ref082","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3109\/09537104.2011.589014","article-title":"The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences","volume":"23","author":"BJ Park","year":"2012","journal-title":"Platelets"},{"issue":"8","key":"pone.0286163.ref083","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1080\/09537100701593601","article-title":"Thrombopoietin is not uniquely responsible for thrombocytosis in inflammatory disorders","volume":"18","author":"IF Ceresa","year":"2007","journal-title":"Platelets"},{"issue":"6","key":"pone.0286163.ref084","doi-asserted-by":"crossref","first-page":"486","DOI":"10.2337\/diab.30.6.486","article-title":"Platelet survival in patients with diabetes mellitus","volume":"30","author":"RL Jones","year":"1981","journal-title":"Diabetes"},{"issue":"4","key":"pone.0286163.ref085","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1160\/TH13-01-0075","article-title":"Thrombosis in central obesity and metabolic syndrome: mechanisms and epidemiology","volume":"110","author":"PE Morange","year":"2013","journal-title":"Thrombosis and haemostasis"},{"issue":"1","key":"pone.0286163.ref086","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1467-789X.2011.00930.x","article-title":"Platelet activation in obesity and metabolic syndrome","volume":"13","author":"F Santilli","year":"2012","journal-title":"Obesity reviews: an official journal of the International Association for the Study of Obesity"},{"key":"pone.0286163.ref087","doi-asserted-by":"crossref","first-page":"118","DOI":"10.3389\/fcvm.2020.00118","article-title":"Platelet Measurements and Type 2 Diabetes: Investigations in Two Population-Based Cohorts","volume":"7","author":"BAT Rodriguez","year":"2020","journal-title":"Frontiers in cardiovascular medicine"},{"issue":"15","key":"pone.0286163.ref088","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.lfs.2013.08.003","article-title":"The role of oxidative stress in alterations of hematological parameters and inflammatory markers induced by early hypercholesterolemia","volume":"93","author":"MS Karbiner","year":"2013","journal-title":"Life sciences"},{"issue":"19","key":"pone.0286163.ref089","doi-asserted-by":"crossref","first-page":"3037","DOI":"10.1182\/blood-2013-12-541672","article-title":"Adherence to the Mediterranean diet is associated with lower platelet and leukocyte counts: results from the Moli-sani study","volume":"123","author":"M Bonaccio","year":"2014","journal-title":"Blood"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0286163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T17:43:57Z","timestamp":1685036637000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0286163"}},"subtitle":[],"editor":[{"given":"Desalegn Admassu","family":"Ayana","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,5,25]]},"references-count":89,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0286163","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,25]]}}}