Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University , Minami-ku, Hiroshima Japan.
Department of Community Medicine, Chiba Medical Center, Teikyo University School of Medicine , Ichihara, Chiba , Japan.
Endocr Res. 2019 Nov;44(4):127-137. doi: 10.1080/07435800.2019.1589494. Epub 2019 Mar 21.
: White blood cell (WBC) count or C-reactive protein (CRP) level alone may not fully indicate the chronic inflammation causing type 2 diabetes. We examined both WBC count and CRP level, independently and in combination, as predictive markers for type 2 diabetes and also considered the influence of obesity and other individual characteristics on the relationship. : In total, 9,706 participants were enrolled with WBC < 10*10/L and CRP < 10 mg/L using data from the Yuport Medical Checkup Center Study. The cumulative incidence of type 2 diabetes [defined either as known diabetes, fasting plasma glucose ≥ 7.0 mmol/L, or HbA1c ≥ 6.5% (47.5 mmol/mol)] was measured. Hazard ratios (HRs) were estimated using a Cox proportional hazards model. : During study period, 272 men (5.5%) and 113 women (2.4%) progressed to diabetes. The progression to diabetes was predicted by both increased baseline levels of WBC count [adjusted HR = 1.29 (95% CI: 1.04-1.60)] and CRP level [1.39 (1.10-1.74)], even after adjusting for possible confounders. The combined presence was more predictive of diabetes than either alone in a four-groups analysis [1.75 (1.28-2.40)]. In addition, the elevated HRs of either or both higher WBC and CRP levels were observed across four subgroups of body mass index (BMI), including low BMI, and people who had at least one occurrence of dyslipidemia. : Increased WBC counts and CRP levels were predictive for type 2 diabetes and the combination augmented the risk of diabetes, regardless of whether the BMI was high or low.
白细胞计数或 C 反应蛋白水平单独可能无法充分表明导致 2 型糖尿病的慢性炎症。我们分别检查了白细胞计数和 C 反应蛋白水平,并将其作为 2 型糖尿病的预测指标进行组合,同时还考虑了肥胖和其他个体特征对这种关系的影响。
共有 9706 名参与者使用Yuport 医疗检查中心研究的数据,其白细胞计数<10*10/L 和 C 反应蛋白<10mg/L 被纳入研究。使用 Cox 比例风险模型估计了糖尿病的累积发生率[定义为已知糖尿病、空腹血糖≥7.0mmol/L 或 HbA1c≥6.5%(47.5mmol/mol)]。
在研究期间,272 名男性(5.5%)和 113 名女性(2.4%)进展为糖尿病。基线白细胞计数增加[调整后的 HR=1.29(95%CI:1.04-1.60)]和 C 反应蛋白水平增加[1.39(1.10-1.74)]均预测了糖尿病的进展,即使在调整了可能的混杂因素后也是如此。在四组分析中,联合存在比单独存在更能预测糖尿病[1.75(1.28-2.40)]。此外,在四个身体质量指数(BMI)亚组中,包括低 BMI 和至少一次血脂异常的人群,无论 BMI 高低,白细胞计数和 C 反应蛋白水平升高的 HR 均升高。
白细胞计数和 C 反应蛋白水平升高可预测 2 型糖尿病,且联合升高会增加糖尿病的风险,无论 BMI 是高还是低。