The mean corpuscular volume (MCV), a crucial measurement for identifying the underlying cause of anemia, has been found to have associations with body composition, sarcopenia, and visceral obesity. This article explores the connection between MCV and weight loss, delving into the clinical implications and potential mechanisms involved.
Understanding Mean Corpuscular Volume (MCV)
MCV is a laboratory value that measures the average size and volume of red blood cells (RBCs), providing essential information in the diagnostic process for anemia. It is expressed as femtoliters (fL) and is calculated using the formula:
MCV (in fL) = (Hematocrit %)/(RBC×10^12/L)×10
MCV classifies anemia into three main categories: microcytic, normocytic, and macrocytic. MCV levels below, within, and above the normal range define these categories, respectively. Microcytic anemia is characterized by erythrocytes smaller than normal (MCV < 80 fL), while macrocytic anemia is characterized by an increased average RBC volume (MCV > 100 fL). Normocytic anemia has a normal MCV range of 80 to 100 fL.
The Link Between MCV and Body Composition
A cross-sectional study involving 702 middle-aged Japanese individuals without anemia and with normal MCV levels revealed significant associations between MCV and body composition. The study, which involved physical checkups and computed tomography (CT) scans, found that lower MCV was associated with unfavorable body composition.
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Specifically, the MCV was independently associated with the visceral fat area index (VFA index), total skeletal muscle index (SMI), and total skeletal muscle density (SMD). Lower MCV levels were also related to a higher prevalence of sarcopenia and visceral obesity. These findings suggest that MCV may serve as a potential marker for assessing muscle quality, muscle quantity, sarcopenia, and visceral obesity.
MCV, Sarcopenia, and Visceral Obesity
Sarcopenia and visceral obesity are major global public health issues. Sarcopenia is characterized by the loss of muscle mass and strength, while visceral obesity refers to the accumulation of excess fat around the abdominal organs. Both conditions are associated with adverse health outcomes, including increased risk of cardiovascular disease, diabetes, and mortality.
The study mentioned above found that lower MCV levels were associated with a higher prevalence of both sarcopenia and visceral obesity. This suggests that MCV may be a useful tool for identifying individuals at risk for these conditions.
Potential Mechanisms Linking MCV and Body Composition
Several potential mechanisms may explain the association between MCV and body composition. One possible mechanism involves inflammation and oxidative stress, which are often elevated in individuals with obesity. Obesity is associated with an increase in inflammation, which is related to an increase in oxidative stress.
Another potential mechanism relates to cell dehydration, shrinkage, or swelling. MCV might be a biomarker of cell dehydration, shrinkage or swelling. Arginine vasopressin secretion increases with increasing crystal osmotic pressure, which is associated with lower MCV levels.
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Clinical Implications and Future Directions
The findings discussed above have several clinical implications. First, MCV, which can be easily measured in the clinical laboratory, may serve as a provisional new marker of lower muscle quality, lower muscle quantity, sarcopenia, and visceral obesity.
Second, the concept of a role for MCV in unfavorable body composition holds great promise for the development of new preventive measures for individuals who are generally considered healthy. For the individuals who are generally considered healthy, the interesting concept of a role for MCV in unfavorable body composition holds great promise for the development of new preventive measures.
However, it is important to note that the cross-sectional nature of the study does not permit determination of causality. Further research is needed to determine whether MCV is a surrogate or predictable marker for clinical outcome.
MCV and Anemia: A Closer Look
Microcytic Anemia
Microcytic anemia is characterized by erythrocytes that are smaller than normal, with an MCV measurement below 80 fL on a complete blood count (CBC). This type of anemia is commonly associated with chronic iron-deficiency anemia, sideroblastic anemia, and thalassemias, although the anemia can also occur in other conditions.
Macrocytic Anemia
Macrocytic anemia is characterized by an increased average RBC volume compared to normal levels, with an MCV measurement exceeding 100 fL on a CBC. Macrocytic anemia is further categorized into megaloblastic, characterized by impaired DNA synthesis, or non-megaloblastic, where DNA synthesis remains normal. Megaloblastic anemia is commonly caused by folate deficiencies (folic acid or vitamin B9), cobalamin/vitamin B12, or orotic aciduria. On the other hand, non-megaloblastic anemia can result from hepatic insufficiency, chronic alcoholism, or a rare congenital disease known as Diamond-Blackfan anemia.
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Normocytic Anemia
Normocytic anemia has a low hemoglobin and hematocrit range, but MCV is in the normal range of 80 to 100 fL. This type of anemia can be subclassified into hemolytic or non-hemolytic. Normocytic hemolytic anemia can occur intravascularly and extravascularly due to various underlying causes. Other laboratory values on the CBC further indicate the type of anemia, aiding in diagnosis. Non-hemolytic normocytic anemias may present in conditions such as early anemia of chronic disease, early iron-deficiency anemia, aplastic anemia, microangiopathic hemolytic anemias, and certain plasmodial infections.
VCU Weight Control Seminars
Virginia Commonwealth University (VCU) offers weight control seminars called "Food & Fitness: Health for a Lifetime." These seminars focus on balancing protein, carbohydrates, and fat for healthy weight loss. Participants learn about the hazards of various fad diets and strategies for weight loss success. Healthy recipes are available, along with taste tests of low-fat foods.
The seminars are held at VCU’s Medical College of Virginia Women’s HealthCare, 9000 Stony Point Parkway. The cost is $30 per person or $49 for two people with the same address.
The Role of Medical Professionals in Weight Loss
Jeffrey Sicat, MD, FACE, MFOMA (Endocrinology, Obesity Medicine), is a physician with extensive training in weight loss medicine. He is board certified in bariatric medicine by the American Board of Obesity Medicine (ABOM) as well as the American Board of Bariatric Medicine (ABBM). Dr. Sicat is also a member of several professional organizations, including the Obesity Medicine Association (OMA) / American Society of Bariatric Physicians, American Association of Clinical Endocrinologists, The Endocrine Society, the American Medical Association, and the Medical Society of Virginia.
Dr. Sicat's approach to weight loss involves developing personalized strategies for his patients. He understands the challenges of losing and maintaining a healthy weight, having personally lost weight using the strategies and techniques he has learned through his professional training.
COVID-19 and Weight Loss
A VCU survey of 322 respondents showed that 37% of COVID-19 survivors with loss of smell or taste experienced weight loss. This may be due to the fact that people with smell or taste loss report less enjoyment of food.