Bulum T, Kolarić B, Duvnjak L, Vrhovac R
Vuk Vrhovac Clinic for Diabetes Endocrinology and Metabolic Diseases University Hospital Merkur, School of Medicine University of Zagreb, Croatia -
Minerva Endocrinol. 2014 Jun;39(2):119-26.
Previous studies reported independent associations of hematological parameters with insulin resistance. The aim of this study was to explore the associations of hematological parameters, including red blood cell count (RBC), hemoglobin (Hgb), white blood cell count (WBC), and platelets with insulin resistance in type 1 diabetes.
Study included 353 patients with type 1 diabetes. None showed signs of acute or chronic inflammatory, renal and cardiovascular diseases. Insulin sensitivity was measured with estimated glucose disposal rate (eGDR) calculated with the equation: eGDR=24.31-(12.22xWHR)-(3.29xAHT)-(0.57xHbA1c). The units were mg.kg-1min-1; WHR=waist to hip ratio; AHT=hypertension.
RBC, Hgb, and WBC significantly correlated with insulin resistance measured by eGDR (r=-0.12, -0.21, and -0.14, respectively, all P≤0.01), and its components disorders, most notably WHR (r=0.38, 0.44, and 0.16, respectively, all P≤0.001). In a multiple logistic regression analysis after adjustment for age, sex, duration of diabetes and BMI, the presence of insulin resistance was independently associated with WBC count (odds ratio=1.28, P<0.01). The risk of insulin resistance increases by a factor of 4.41 for those in the 4th quartile of WBC, compared to those in 1st quartile.
The significant independent association of WBC with the presence of insulin resistance suggests a role of subclinical inflammation in its pathogenesis.
既往研究报道了血液学参数与胰岛素抵抗之间的独立关联。本研究旨在探讨包括红细胞计数(RBC)、血红蛋白(Hgb)、白细胞计数(WBC)和血小板在内的血液学参数与1型糖尿病患者胰岛素抵抗之间的关联。
研究纳入了353例1型糖尿病患者。所有患者均无急慢性炎症、肾脏和心血管疾病迹象。采用通过公式计算的估计葡萄糖处置率(eGDR)来测量胰岛素敏感性:eGDR = 24.31 -(12.22×腰臀比)-(3.29×高血压)-(0.57×糖化血红蛋白)。单位为mg·kg⁻¹·min⁻¹;腰臀比 = 腰围与臀围之比;高血压指高血压状态。
RBC、Hgb和WBC与通过eGDR测量的胰岛素抵抗显著相关(r分别为-0.12、-0.21和-0.14,均P≤0.01),以及其组成部分的紊乱,最显著的是腰臀比(r分别为0.38、0.44和0.16,均P≤0.001)。在对年龄、性别、糖尿病病程和体重指数进行调整后的多因素逻辑回归分析中,胰岛素抵抗的存在与白细胞计数独立相关(比值比 = 1.28,P<0.01)。与第一四分位数的患者相比,白细胞处于第四四分位数的患者发生胰岛素抵抗的风险增加4.41倍。
白细胞与胰岛素抵抗的存在之间存在显著的独立关联,提示亚临床炎症在其发病机制中起作用。