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2型糖尿病患者外周血白细胞总数及分类计数与代谢综合征和缺血性心血管疾病风险的关联

Association of peripheral total and differential leukocyte counts with metabolic syndrome and risk of ischemic cardiovascular diseases in patients with type 2 diabetes mellitus.

作者信息

Tsai Jack C-R, Sheu Sheng-Hsiung, Chiu Herng-Chia, Chung Fu-Mei, Chang Dao-Ming, Chen Miao-Pei, Shin Shyi-Jang, Lee Yau-Jiunn

机构信息

Department of Clinical Research, Pingtung Christian Hospital, Pingtung, 90000, Taiwan.

出版信息

Diabetes Metab Res Rev. 2007 Feb;23(2):111-8. doi: 10.1002/dmrr.647.

Abstract

BACKGROUND

There is increasing evidence that leukocytes play a central role in obesity, glucose intolerance, type 2 diabetes mellitus (T2DM), and cardiovascular diseases, but the role of differential leukocytes in metabolic syndrome (MetS) and atherosclerosis is largely unknown. The aim of this study was to examine the relationship between the component features of MetS and peripheral leukocyte counts and to explore whether leukocyte counts are associated with clustering of MetS and macrovascular diseases in patients with T2DM.

METHODS

1872 subjects with T2DM who enrolled in a diabetes disease management program were studied. The definition of MetS was modified from that outlined by the criteria of NCEP-ATP III. Areas under the receiver-operating characteristic curve and odds ratios at various intervals of the WBC counts were computed.

RESULTS

The peripheral total leukocyte, monocyte, and neutrophil cell counts are increased parallel to the clustering of components of MetS. When white cell counts were analyzed per quartile and as continuous variables after adjustment for age, sex, and other known risk factors with multiple regression analysis, peripheral total leukocyte, monocyte, neutrophils, and lymphocyte counts were independently and significantly associated with specific features of clustering of MetS and prevalence of ischemic cardiovascular diseases. Leukocyte counts, especially neutrophil/lymphocyte ratio, in addition with MetS is associated with the risk of ischemic cardiovascular diseases.

CONCLUSION

Our results indicate that differential leukocyte counts are associated with MetS and that peripheral leukocytes may play a role in the pathogenesis of macrovascular complications in patients with T2DM.

摘要

背景

越来越多的证据表明,白细胞在肥胖、糖耐量异常、2型糖尿病(T2DM)和心血管疾病中起核心作用,但不同类型白细胞在代谢综合征(MetS)和动脉粥样硬化中的作用在很大程度上尚不清楚。本研究的目的是探讨MetS的组成特征与外周血白细胞计数之间的关系,并探讨白细胞计数是否与T2DM患者的MetS聚集和大血管疾病相关。

方法

对参加糖尿病疾病管理项目的1872例T2DM患者进行研究。MetS的定义是根据美国国家胆固醇教育计划成人治疗组第三次报告(NCEP-ATP III)标准修改而来。计算了白细胞计数在不同区间的受试者工作特征曲线下面积和比值比。

结果

外周血总白细胞、单核细胞和中性粒细胞计数随着MetS各组分的聚集而平行增加。当按四分位数分析白细胞计数,并在多元回归分析中对年龄、性别和其他已知危险因素进行校正后将其作为连续变量分析时,外周血总白细胞、单核细胞、中性粒细胞和淋巴细胞计数与MetS聚集的特定特征和缺血性心血管疾病的患病率独立且显著相关。白细胞计数,尤其是中性粒细胞/淋巴细胞比值,与MetS一起与缺血性心血管疾病的风险相关。

结论

我们的结果表明,不同类型白细胞计数与MetS相关,外周血白细胞可能在T2DM患者大血管并发症的发病机制中起作用。

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