Top

Endocrine

Published in:

01-05-2020 | Original Article

Leukocyte-related parameters in older adults with metabolic syndrome

Authors: Xue-Jiao Yang, Shun Tian, Qing-Hua Ma, Hong-Peng Sun, Yong Xu, Chen-Wei Pan

Published in: Endocrine | Issue 2/2020

Abstract

Purpose

We aimed to examine the association between leukocyte-related parameters and the risk of metabolic syndrome (MetS) in community-dwelling older Chinese adults, with a special focus on assessing the diagnostic ability of leukocyte-related parameters in detecting MetS and the potential interaction effect of sex in the leukocyte–MetS relationship.

Methods

Study sample was from the Weitang Geriatric Diseases Study, which included 4579 individuals aged 60 years or above. MetS was diagnosed based on the Adult Treatment Panel III criteria. Leukocyte-related parameters were assessed using an automated hematology analyzer.

Results

The adjusted odds ratio (95% confidence interval (CI)) of MetS for the highest quartile of leukocyte-related parameters (leukocyte, lymphocyte, neutrophil, monocyte, eosinophil, and basophil), when compared with the lowest quartile were 2.87 (2.30, 3.59), 2.69 (2.15, 3.36), 2.09 (1.67, 2.62), 2.12 (1.71, 2.64), 1.62 (1.31, 2.00), and 1.36 (1.11, 1.65), respectively. Adding leukocyte, lymphocyte, monocyte, and neutrophil to a model containing conventional risk factors improved risk prediction for MetS. Furthermore, significant interactions between leukocyte, monocyte, neutrophil, and sex on MetS were observed (all P value for interaction <0.01).

Conclusion

The numbers of total leukocytes, lymphocyte, monocyte, neutrophil, and eosinophil counts were elevated in older adults with MetS, suggesting that leukocyte-related parameters may be meaningful biomarkers for MetS. Adding leukocyte-related parameters to the conventional models increased the ability of predicting MetS among older adults. These parameters may be useful biomarkers for further risk appraisal of MetS in older adults.

R.H. Eckel, S.M. Grundy, P.Z. Zimmet, The metabolic syndrome. Lancet 365(9468), 1415–1428 (2005)CrossRef

J. Lu, L. Wang, M. Li, Y. Xu, Y. Jiang, W. Wang, J. Li, S. Mi, M. Zhang, Y. Li, T. Wang, M. Xu, Z. Zhao, M. Dai, S. Lai, W. Zhao, L. Wang, Y. Bi, G. Ning, Metabolic syndrome among adults in China: the 2010 China Noncommunicable Disease Surveillance. J. Clin. Endocrinol. Metab. 102(2), 507–515 (2017)PubMed

B. Isomaa, P. Almgren, T. Tuomi, B. Forsen, K. Lahti, M. Nissen, M.R. Taskinen, L. Groop, Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24(4), 683–689 (2001)CrossRef

X. Huo, L. Gao, L. Guo, W. Xu, W. Wang, X. Zhi, L. Li, Y. Ren, X. Qi, Z. Sun, W. Li, Q. Ji, X. Ran, B. Su, C. Hao, J. Lu, X. Guo, H. Zhuo, D. Zhang, C. Pan, J. Weng, D. Hu, X. Yang, L. Ji, Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: a cross-sectional study. Lancet Diabetes Endocrinol. 4(2), 115–124 (2016)CrossRef

P. Zimmet, D. Magliano, Y. Matsuzawa, G. Alberti, J. Shaw, The metabolic syndrome: a global public health problem and a new definition. J. Atheroscler. Thromb. 12(6), 295–300 (2005)CrossRef

P. Dandona, A. Aljada, A. Chaudhuri, P. Mohanty, R. Garg, Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 111(11), 1448–1454 (2005)CrossRef

G.S. Hotamisligil, Inflammation and metabolic disorders. Nature 444(7121), 860–867 (2006)CrossRef

W. Meng, C. Zhang, Q. Zhang, X. Song, H. Lin, D. Zhang, Y. Zhang, Z. Zhu, S. Wu, Y. Liu, F. Tang, X. Yang, F. Xue, Association between leukocyte and metabolic syndrome in urban Han Chinese: a longitudinal cohort study. PloS One 7(11), e49875 (2012)CrossRef

A. Jesri, E.C. Okonofua, B.M. Egan, Platelet and white blood cell counts are elevated in patients with the metabolic syndrome. J. Clin. Hypertens. 7(12), 705–711 (2005)CrossRef

10.

N. Nagasawa, K. Tamakoshi, H. Yatsuya, Y. Hori, M. Ishikawa, C. Murata, H. Zhang, K. Wada, R. Otsuka, T. Mabuchi, T. Kondo, H. Toyoshima, Association of white blood cell count and clustered components of metabolic syndrome in Japanese men. Circ. J. 68(10), 892–897 (2004)CrossRef

11.

E. Oda, R. Kawai, The prevalence of metabolic syndrome and diabetes increases through the quartiles of white blood cell count in Japanese men and women. Intern. Med. 48(13), 1127–1134 (2009)CrossRef

12.

K. Odagiri, A. Uehara, I. Mizuta, M. Yamamoto, C. Kurata, Longitudinal study on white blood cell count and the incidence of metabolic syndrome. Intern. Med. 50(21), 2491–2498 (2011)CrossRef

13.

D. Fairweather, S. Frisancho-Kiss, N.R. Rose, Sex differences in autoimmune disease from a pathological perspective. Am. J. Pathol. 173(3), 600–609 (2008)CrossRef

14.

C.W. Pan, X. Wang, Q. Ma, H.P. Sun, Y. Xu, P. Wang, Cognitive dysfunction and health-related quality of life among older Chinese. Sci. Rep. 5, 17301 (2015)CrossRef

15.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19), 2486–2497 (2001). https://doi.org/10.1001/jama.285.19.2486

16.

M.J. Pencina, R.B. D’Agostino, R.B. D’Agostino Sr., R.S. Vasan Jr., Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat. Med. 27(2), 157–172 (2008). https://doi.org/10.1002/sim.2929 CrossRefPubMed

17.

B.D. Horne, J.L. Anderson, J.M. John, A. Weaver, T.L. Bair, K.R. Jensen, D.G. Renlund, J.B. Muhlestein, Which white blood cell subtypes predict increased cardiovascular risk? J. Am. Coll. Cardiol. 45(10), 1638–1643 (2005). https://doi.org/10.1016/j.jacc.2005.02.054 CrossRefPubMed

18.

P.M. Sweetnam, H.F. Thomas, J.W. Yarnell, I.A. Baker, P.C. Elwood, Total and differential leukocyte counts as predictors of ischemic heart disease: the Caerphilly and Speedwell studies. Am. J. Epidemiol. 145(5), 416–421 (1997). https://doi.org/10.1093/oxfordjournals.aje.a009123 CrossRefPubMed

19.

B.Y. Su, C.F. Tian, B.L. Gao, Y.H. Tong, X.H. Zhao, Y. Zheng, Correlation of the leucocyte count with traditional and non-traditional components of metabolic syndrome. Postgrad. Med. 128(8), 805–809 (2016). https://doi.org/10.1080/00325481.2016.1243980 CrossRefPubMed

20.

J.A. Kim, Y.S. Choi, J.I. Hong, S.H. Kim, H.H. Jung, S.M. Kim, Association of metabolic syndrome with white blood cell subtype and red blood cells. Endocr. J. 53(1), 133–139 (2006)CrossRef

21.

H. Yang, Y.Q. Fu, B. Yang, J.S. Zheng, X.Y. Zeng, W. Zeng, Z.F. Fan, M. Chen, L. Wang, D. Li, Positive association between the metabolic syndrome and white blood cell counts in Chinese. Asia Pac. J. Clin. Nutr. 26(1), 141–147 (2017). https://doi.org/10.6133/apjcn.102015.13 CrossRefPubMed

22.

X.Q. Lao, G. Neil Thomas, C. Jiang, W. Zhang, P. Adab, T.H. Lam, K.K. Cheng, White blood cell count and the metabolic syndrome in older Chinese: the Guangzhou Biobank Cohort Study. Atherosclerosis 201(2), 418–424 (2008). https://doi.org/10.1016/j.atherosclerosis.2007.12.053 CrossRefPubMed

23.

A.E. Kitabchi, M. Temprosa, W.C. Knowler, S.E. Kahn, S.E. Fowler, S.M. Haffner, R. Andres, C. Saudek, S.L. Edelstein, R. Arakaki, M.B. Murphy, H. Shamoon, Role of insulin secretion and sensitivity in the evolution of type 2 diabetes in the diabetes prevention program: effects of lifestyle intervention and metformin. Diabetes 54(8), 2404–2414 (2005). https://doi.org/10.2337/diabetes.54.8.2404 CrossRefPubMed

24.

B. Razani, M.V. Chakravarthy, C.F. Semenkovich, Insulin resistance and atherosclerosis. Endocrinol. Metab. Clin. N. Am. 37(3), 603–621, viii (2008). https://doi.org/10.1016/j.ecl.2008.05.001 CrossRef

25.

S. Hagita, M. Osaka, K. Shimokado, M. Yoshida, Adipose inflammation initiates recruitment of leukocytes to mouse femoral artery: role of adipo-vascular axis in chronic inflammation. PloS One 6(5), e19871 (2011). https://doi.org/10.1371/journal.pone.0019871 CrossRefPubMedPubMedCentral

26.

N. Kawanishi, H. Yano, Y. Yokogawa, K. Suzuki, Exercise training inhibits inflammation in adipose tissue via both suppression of macrophage infiltration and acceleration of phenotypic switching from M1 to M2 macrophages in high-fat-diet-induced obese mice. Exerc. Immunol. Rev. 16, 105–118 (2010)PubMed

27.

K. Ohashi, J.L. Parker, N. Ouchi, A. Higuchi, J.A. Vita, N. Gokce, A.A. Pedersen, C. Kalthoff, S. Tullin, A. Sams, R. Summer, K. Walsh, Adiponectin promotes macrophage polarization toward an anti-inflammatory phenotype. J. Biol. Chem. 285(9), 6153–6160 (2010). https://doi.org/10.1074/jbc.M109.088708 CrossRefPubMed

28.

K. Li, W. Xu, Q. Guo, Z. Jiang, P. Wang, Y. Yue, S. Xiong, Differential macrophage polarization in male and female BALB/c mice infected with coxsackievirus B3 defines susceptibility to viral myocarditis. Circ. Res. 105(4), 353–364 (2009). https://doi.org/10.1161/circresaha.109.195230 CrossRefPubMed

29.

N. Nakanishi, K. Suzuki, K. Tatara, White blood cell count and clustered features of metabolic syndrome in Japanese male office workers. Occup. Med. 52(4), 213–218 (2002). https://doi.org/10.1093/occmed/52.4.213 CrossRef

30.

V. Mohamed-Ali, S. Goodrick, A. Rawesh, D.R. Katz, J.M. Miles, J.S. Yudkin, S. Klein, S.W. Coppack, Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J. Clin. Endocrinol. Metab. 82(12), 4196–4200 (1997). https://doi.org/10.1210/jcem.82.12.4450 CrossRefPubMed

31.

M. Benagiano, A. Azzurri, A. Ciervo, A. Amedei, C. Tamburini, M. Ferrari, J.L. Telford, C.T. Baldari, S. Romagnani, A. Cassone, M.M. D’Elios, G. Del Prete, T helper type 1 lymphocytes drive inflammation in human atherosclerotic lesions. Proc. Natl Acad. Sci. USA 100(11), 6658–6663 (2003). https://doi.org/10.1073/pnas.1135726100 CrossRefPubMed

32.

B. Osterud, Tissue factor/TFPI and blood cells. Thromb. Res. 129(3), 274–278 (2012). https://doi.org/10.1016/j.thromres.2011.11.049 CrossRefPubMed

33.

N.P. Kumar, K. Moideen, Y. Bhootra, A. Nancy, V. Viswanathan, B.S. Shruthi, S. Sivakumar, M. Natarajan, H. Kornfeld, S. Babu, Elevated circulating levels of monocyte activation markers among tuberculosis. Immunology 156(3), 249–258 (2019). https://doi.org/10.1111/imm.13023 CrossRefPubMed

34.

E. Palella, R. Cimino, S.A. Pullano, A.S. Fiorillo, E. Gulletta, A. Brunetti, D.P. Foti, M. Greco, Laboratory parameters of hemostasis, adhesion molecules, and inflammation in type 2 diabetes mellitus: correlation with glycemic control. Int. J. Environ. Res. Public. Health 17(1), E300 (2020). https://doi.org/10.3390/ijerph17010300 CrossRefPubMed

35.

G. Twig, A. Afek, A. Shamiss, E. Derazne, D. Tzur, B. Gordon, A. Tirosh, White blood cells count and incidence of type 2 diabetes in young men. Diabetes Care 36(2), 276–282 (2013). https://doi.org/10.2337/dc11-2298 CrossRefPubMedPubMedCentral

36.

K.C. Sung, S. Ryu, J.W. Sung, Y.B. Kim, Y.S. Won, D.S. Cho, S.H. Kim, A. Liu, Inflammation in the prediction of type 2 diabetes and hypertension in healthy. Arch. Med. Res. 48(6), 535–545 (2017). https://doi.org/10.1016/j.arcmed.2017.11.010 CrossRefPubMed

37.

E.S. Androulakis, D. Tousoulis, N. Papageorgiou, C. Tsioufis, I. Kallikazaros, C. Stefanadis, Essential hypertension: is there a role for inflammatory mechanisms?. Cardiol. Rev. 17(5), 216–221 (2009). https://doi.org/10.1097/CRD.0b013e3181b18e03 CrossRefPubMed

38.

D.J. Kim, J.H. Noh, B.W. Lee, Y.H. Choi, J.H. Chung, Y.K. Min, M.S. Lee, M.K. Lee, K.W. Kim, The associations of total and differential white blood cell counts with obesity, hypertension, dyslipidemia and glucose intolerance in a Korean population. J. Korean Med. Sci. 23(2), 193–198 (2008). https://doi.org/10.3346/jkms.2008.23.2.193 CrossRefPubMedPubMedCentral

39.

V. Lohsoonthorn, W. Jiamjarasrungsi, M.A. Williams, Association of hematological parameters with clustered components of metabolic syndrome among professional and office workers in Bangkok, Thailand. Diabetes Metab. Syndr. 1(3), 143–149 (2007). https://doi.org/10.1016/j.dsx.2007.05.002 CrossRefPubMedPubMedCentral

40.

P. Zhou, Z. Meng, M. Liu, X. Ren, M. Zhu, Q. He, Q. Zhang, L. Liu, K. Song, Q. Jia, J. Tan, X. Li, N. Liu, T. Hu, A. Upadhyaya, The associations between leukocyte, erythrocyte or platelet, and metabolic syndrome in different genders of Chinese. Medicine 95(44), e5189 (2016). https://doi.org/10.1097/md.0000000000005189 CrossRefPubMedPubMedCentral

41.

N. Ishizaka, Y. Ishizaka, E. Toda, R. Nagai, M. Yamakado, Association between cigarette smoking, white blood cell count, and metabolic syndrome as defined by the Japanese criteria. Intern. Med. 46(15), 1167–1170 (2007). https://doi.org/10.2169/internalmedicine.46.0136 CrossRefPubMed

42.

Y. Ogawa, M. Imaki, Y. Yoshida, M. Shibakawa, S. Tanada, An epidemiological study on the association between the total leukocyte and neutrophil counts, and risk factors of ischemic heart disease by smoking status in Japanese factory workers. Appl. Hum. Sci. 17(6), 239–247 (1998). https://doi.org/10.2114/jpa.17.239 CrossRef

43.

J. Schwartz, S.T. Weiss, Cigarette smoking and peripheral blood leukocyte differentials. Ann. Epidemiol. 4(3), 236–242 (1994). https://doi.org/10.1016/1047-2797(94)90102-3 CrossRefPubMed

44.

Y.Y. Cheng, T.W. Kao, Y.W. Chang, C.J. Wu, T.C. Peng, L.W. Wu, H.F. Yang, F.Y. Liaw, W.L. Chen, Examining the gender difference in the association between metabolic syndrome and the mean leukocyte telomere length. PLoS ONE 12(7), e0180687 (2017). https://doi.org/10.1371/journal.pone.0180687 CrossRefPubMedPubMedCentral

45.

J.H. Kim, J.A. Im, D.C. Lee, The relationship between leukocyte mitochondrial DNA contents and metabolic syndrome in postmenopausal women. Menopause 19(5), 582–587 (2012). https://doi.org/10.1097/gme.0b013e31823a3e46 CrossRefPubMed

46.

C. Duffaut, A. Zakaroff-Girard, V. Bourlier, P. Decaunes, M. Maumus, P. Chiotasso, C. Sengenes, M. Lafontan, J. Galitzky, A. Bouloumie, Interplay between human adipocytes and T lymphocytes in obesity: CCL20 as an adipochemokine and T lymphocytes as lipogenic modulators. Arterioscler. Thromb. Vasc. Biol. 29(10), 1608–1614 (2009). https://doi.org/10.1161/atvbaha.109.192583 CrossRefPubMed

47.

E. Oda, High-sensitivity C-reactive protein and white blood cell count equally predict development of the metabolic syndrome in a Japanese health screening population. Acta Diabetol. 50(4), 633–638 (2013). https://doi.org/10.1007/s00592-013-0477-7 CrossRefPubMed

48.

E. Oda, R. Kawai, Comparison between high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) as an inflammatory component of metabolic syndrome in Japanese. Intern. Med. 49(2), 117–124 (2010). https://doi.org/10.2169/internalmedicine.49.2670 CrossRefPubMed

Title: Leukocyte-related parameters in older adults with metabolic syndrome
Authors: Xue-Jiao Yang
Shun Tian
Qing-Hua Ma
Hong-Peng Sun
Yong Xu
Chen-Wei Pan
Publication date: 01-05-2020
Publisher: Springer US
Published in: Endocrine / Issue 2/2020
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02243-2

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2020

Constitutive TSH receptor activation as a hallmark of thyroid autonomy

Severe hypocalcemia in a thyroidectomized woman with Covid-19 infection

Prediction of hypertension, diabetes and fractures in eucortisolemic women by measuring parameters of cortisol milieu

A journey through and beyond a “perfect storm”: the COVID-19 pandemic

Performance of a dual-component molecular assay in cytologically indeterminate thyroid nodules

Use of the Thyroid Imaging Reporting and Data System (TIRADS) in clinical practice: an Italian survey

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage