Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA.
Nutr Diabetes. 2024 May 17;14(1):30. doi: 10.1038/s41387-024-00271-9.
Although central adiposity is a well-known risk factor for diabetes, the underlying mechanism remains unclear. The aim of this study was to explore the potential mediation role of circulating WBC counts in the association between central adiposity and the risk of diabetes.
A cross-sectional study was conducted using data from the Fuqing cohort study, which included 6,613 participants aged 35-75 years. Logistic regression analysis and Spearman's rank correlation analysis were used to examine the relationships between waist-to-hip ratio, WBC counts and glycemic status. Both simple and parallel multiple mediation models were used to explore the potential mediation effects of WBCs on the association of waist-to-hip ratio with diabetes.
The study revealed a positive relationship between waist-to-hip ratio and risk of prediabetes (OR = 1.53; 95% CI, 1.35 to 1.74) and diabetes (OR = 2.89; 95% CI, 2.45 to 3.40). Moreover, elevated peripheral WBC counts were associated with both central adiposity and worsening glycemic status (P < 0.05). The mediation analysis with single mediators demonstrated that there is a significant indirect effect of central adiposity on prediabetes risk through total WBC count, neutrophil count, lymphocyte count, and monocyte count; the proportions mediated were 9.92%, 6.98%, 6.07%, and 3.84%, respectively. Additionally, total WBC count, neutrophil count, lymphocyte count, monocyte count and basophil count mediated 11.79%, 11.51%, 6.29%, 4.78%, and 1.76%, respectively, of the association between central adiposity and diabetes. In the parallel multiple mediation model using all five types of WBC as mediators simultaneously, a significant indirect effect (OR = 1.09; 95% CI, 1.06 to 1.14) were observed, with a mediated proportion of 12.77%.
Central adiposity was independently associated with an elevated risk of diabetes in a Chinese adult population; levels of circulating WBC may contribute to its underlying mechanisms.
尽管中心性肥胖是糖尿病的一个众所周知的危险因素，但潜在机制仍不清楚。本研究旨在探讨循环白细胞计数（WBC）在中心性肥胖与糖尿病风险之间的关联中的潜在中介作用。
使用来自福清队列研究的数据进行横断面研究，该研究纳入了 6613 名年龄在 35-75 岁的参与者。采用 logistic 回归分析和 Spearman 秩相关分析来检验腰围-臀围比、WBC 计数和血糖状态之间的关系。采用简单和并行多重中介模型来探讨 WBC 对腰围-臀围比与糖尿病关联的潜在中介作用。
研究表明，腰围-臀围比与糖尿病前期（OR=1.53；95%CI，1.35 至 1.74）和糖尿病（OR=2.89；95%CI，2.45 至 3.40）的风险呈正相关。此外，外周血白细胞计数升高与中心性肥胖和血糖恶化均相关（P<0.05）。单中介物的中介分析表明，中心性肥胖通过总 WBC 计数、中性粒细胞计数、淋巴细胞计数和单核细胞计数对糖尿病前期风险有显著的间接影响；中介比例分别为 9.92%、6.98%、6.07%和 3.84%。此外，总 WBC 计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数和嗜碱性粒细胞计数分别介导了中心性肥胖与糖尿病之间关联的 11.79%、11.51%、6.29%、4.78%和 1.76%。在使用所有五种类型的 WBC 作为中介物的并行多重中介模型中，观察到显著的间接效应（OR=1.09；95%CI，1.06 至 1.14），中介比例为 12.77%。
在中国人成年人群中，中心性肥胖与糖尿病风险的升高独立相关；循环 WBC 水平可能有助于其潜在机制。
