High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes
High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes
复制标题
DOI：
10.2337/diabetes.51.2.455
复制
发表时间：
2002-02-01
期刊：
影响因子：
7.7
通讯作者：
Tataranni, PA
中科院分区：
文献类型：
--
作者：
Vozarova, B;Weyer, C;Tataranni, PA
慢性低度炎症可能参与了胰岛素抵抗和2型糖尿病的发病机制。我们研究了高白细胞计数(炎症的标志)是否预示着皮马印第安人的胰岛素作用、胰岛素分泌功能和2型糖尿病的恶化。我们测量了352名非糖尿病PIMA印第安人(215名男性和137名女性，年龄27+/-6岁[Means+/-SD]，体脂32+/-8%，WBC 8,107+/-2,022个/mm(3))，他们的特征是身体成分(通过水密度法或双能X射线吸收法)、葡萄糖耐量(通过75克口服葡萄糖耐量试验)、胰岛素作用(M；通过高胰岛素钳夹)和急性胰岛素分泌反应(空气；通过25克静脉葡萄糖挑战)。在272名基线糖耐量(NGT)正常的受试者中，54人在平均5.5+/-4.4年的随访期内发展为糖尿病。在那些保持非糖尿病的人中，81名受试者进行了M和空气的后续测量。在横断面上，WBC与体脂百分比(r=0.32，P<；0.0001)和M(r=-0.24，P<；0.0001)相关，与空气无关(r=0.06，P=0.4)。在多变量分析中，当调整年龄和性别时，体脂百分比(P<；0.0001)和M(P=0.03)都与白细胞独立相关。经年龄和性别调整后，高WBC值预测糖尿病(相对危险度第90个百分位数与第10个百分位数[95%CI]为2.71.3-5.4，P=0.007)。在对已建立的糖尿病预测因子，即体脂百分比、M和空气进行额外调整后，WBC的预测效果持续存在(相对危险度2.6[1.1-6.2]，P=0.03)。在对随访时间进行调整后，基线时高WBC与随后的M恶化相关(P=0.003)，但与空气恶化无关。在皮马印第安人中，高白细胞预示着胰岛素作用的恶化和2型糖尿病的发展。这些发现与免疫系统的慢性激活可能在2型糖尿病的发病机制中发挥作用的假设一致。
Chronic low-grade inflammation may be involved in the pathogenesis of insulin resistance and type 2 diabetes. We examined whether a high white blood cell count (WBC), a marker of inflammation, predicts a worsening of insulin action, insulin secretory function, and the development of type 2 diabetes in Pima Indians. We measured WBC in 352 nondiabetic Pima Indians (215 men and 137 women, aged 27 +/- 6 years [means +/- SD], body fat 32 +/- 8%, WBC 8,107 +/- 2,022 cells/mm(3)) who were characterized for body composition (by hydrodensitometry or dual-energy X-ray absorptiometry), glucose tolerance (by 75-g oral glucose tolerance test), insulin action (M; by hyperinsulinemic clamp), and acute insulin secretory response (AIR; by 25-g intravenous glucose challenge). Among 272 subjects who were normal glucose tolerant (NGT) at baseline, 54 developed diabetes over an average follow-up of 5.5 +/- 4.4 years. Among those who remained nondiabetic, 81 subjects had follow-up measurements of M and AIR. Cross-sectionally, WBC was related to percent body fat (r = 0.32, P < 0.0001) and M (r = -0.24, P < 0.0001), but not to AIR (r = 0.06, P = 0.4). In a multivariate analysis, when adjusted for age and sex, both percent body fat (P < 0.0001) and M (P = 0.03) were independently associated with WBC. A high WBC value predicted diabetes (relative hazard 90th vs. 10th percentiles [95%CI] of 2.7 [1.3-5.4], P = 0.007) when adjusted for age and sex. The predictive effect of WBC persisted after additional adjustment for established predictors of diabetes, i.e., percent body fat, M, and AIR (relative hazard 2.6 [1.1-6.2], P = 0.03). After adjustment for follow-up duration, a high WBC at baseline was associated with a subsequent worsening of M (P = 0.003), but not a worsening of AIR. A high WBC predicts a worsening of insulin action and the development of type 2 diabetes in Pima Indians. These findings are consistent with the hypothesis that a chronic activation of the immune system may play a role in the pathogenesis of type 2 diabetes.