Herishanu Yair, Rogowski Ori, Polliack Aaron, Marilus Rafael
Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Eur J Haematol. 2006 Jun;76(6):516-20. doi: 10.1111/j.1600-0609.2006.00658.x.
Recently, it was shown that fat tissue produces and releases inflammatory cytokines, and that obesity may be regarded as a state of low-grade inflammation. In this regard, we aimed to establish an association between obesity and persistent leukocytosis.
We present clinical observations of obese subjects primarily referred for further evaluation of leukocytosis without a cause and validated the link between leukocytosis and elevated body mass index (BMI) in a cross-sectional study.
During 1999-2005, 327 patients were referred for further investigation because of persistent leukocytosis. Of these, 15.3% were asymptomatic obese, mostly females, with mild persistent neutrophilia accompanied by elevated acute-phase reactants. After careful evaluation, no recognized cause for leukocytosis was found other than the fact that the patients were obese. During a mean follow-up of 45.6 months, the leukocytosis and the elevated acute-phase reactants persisted and no new causes for leukocytosis were evident. Furthermore, in a cross-sectional analysis of 3716 non-smoker subjects, 62 were found to have leukocytosis. Compared with the population with a normal white blood count range, these subjects with leukocytosis had higher BMI, serum C-reactive protein (CRP) levels, waist circumference, and neutrophil and platelet count (all P < 0.0005). After logistic regression analysis, only BMI was shown to be associated with leukocytosis (P < 0.0005).
Obesity is recognized as a possible cause for reactive leukocytosis. Awareness of this 'obesity-associated leukocytosis' may help the clinician to avoid more extensive and unnecessary diagnostic work-up, particularly in similar obese subjects.
最近的研究表明，脂肪组织会产生并释放炎性细胞因子，肥胖可能被视为一种低度炎症状态。鉴于此，我们旨在确定肥胖与持续性白细胞增多之间的关联。
我们展示了肥胖受试者的临床观察结果，这些受试者主要因白细胞增多且无病因而被转诊以进行进一步评估，并在一项横断面研究中验证了白细胞增多与体重指数（BMI）升高之间的联系。
在1999年至2005年期间，327名患者因持续性白细胞增多而被转诊进行进一步检查。其中，15.3%为无症状肥胖者，大多为女性，伴有轻度持续性中性粒细胞增多，并伴有急性期反应物升高。经过仔细评估，除了患者肥胖这一事实外，未发现其他公认的白细胞增多病因。在平均45.6个月的随访期间，白细胞增多和急性期反应物升高持续存在，且未出现新的白细胞增多病因。此外，在对3716名非吸烟受试者的横断面分析中，发现62人存在白细胞增多。与白细胞计数正常范围的人群相比，这些白细胞增多的受试者BMI、血清C反应蛋白（CRP）水平、腰围以及中性粒细胞和血小板计数均更高（所有P<0.0005）。经过逻辑回归分析，仅BMI与白细胞增多相关（P<0.0005）。
肥胖被认为是反应性白细胞增多的一个可能原因。认识到这种“肥胖相关白细胞增多”可能有助于临床医生避免进行更广泛且不必要的诊断检查，尤其是在类似的肥胖受试者中。
