Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies.
Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies.
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DOI：
10.1371/journal.pone.0013405
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发表时间：
2010-10-18
期刊：
影响因子：
3.7
通讯作者：
Langenberg C
中科院分区：
文献类型：
--
作者：
Gkrania-Klotsas E;Ye Z;Cooper AJ;Sharp SJ;Luben R;Biggs ML;Chen LK;Gokulakrishnan K;Hanefeld M;Ingelsson E;Lai WA;Lin SY;Lind L;Lohsoonthorn V;Mohan V;Muscari A;Nilsson G;Ohrvik J;Chao Qiang J;Jenny NS;Tamakoshi K;Temelkova-Kurktschiev T;Wang YY;Yajnik CS;Zoli M;Khaw KT;Forouhi NG;Wareham NJ;Langenberg C
生物学证据表明，炎症可能导致2型糖尿病(T2D)，流行病学研究表明，高白细胞计数(WBC)与T2D之间存在关联。然而，这种关联还没有得到系统的调查。研究是通过基于计算机和人工搜索来确定的。以前未报道的研究是通过通信寻找的。确定了20项研究(8,647例T2D病例和85,040例非病例)。用随机效应荟萃分析结合WBC与T2D相关性的估计；探索异质性的来源以及发表偏倚的存在。白细胞计数上、下三分位数的综合相对危险度(RR)为1.61(95%CI：1.45；1.79，p = 1.5*10−18)。存在明显的异质性(I2 = 83%)。粒细胞的RR为1.38(95%CI：1.17；1.64，p = 1.5×10−4)；淋巴细胞的RR为1.26(95%CI：1.02；1.56，p = 0.029)；单核细胞的RR为0.93(95%CI：0.68；1.28，p = 0.67)。在横断面研究中，RR为1.74(95%CI：1.49；2.02，p = 7.7×10−13)，而在队列研究中，RR为1.48(95%CI：1.22；1.79，p = 7.7×10−5)。我们在EPIC-诺福克研究中评估了混淆的影响，发现在进一步考虑吸烟、T2D家族史、体力活动、教育程度、BMI和腰围后，年龄和性别调整后的HR从2.19(95%CI：1.74；2.75)下降到1.82(95%CI：1.45；2.29)。WBC升高与T2D的风险增加相关。所有研究中存在的发表偏差和未能控制所有潜在的混杂因素意味着所观察到的关联可能是高估的。
Biological evidence suggests that inflammation might induce type 2 diabetes (T2D), and epidemiological studies have shown an association between higher white blood cell count (WBC) and T2D. However, the association has not been systematically investigated. Studies were identified through computer-based and manual searches. Previously unreported studies were sought through correspondence. 20 studies were identified (8,647 T2D cases and 85,040 non-cases). Estimates of the association of WBC with T2D were combined using random effects meta-analysis; sources of heterogeneity as well as presence of publication bias were explored. The combined relative risk (RR) comparing the top to bottom tertile of the WBC count was 1.61 (95% CI: 1.45; 1.79, p = 1.5*10−18). Substantial heterogeneity was present (I2 = 83%). For granulocytes the RR was 1.38 (95% CI: 1.17; 1.64, p = 1.5*10−4), for lymphocytes 1.26 (95% CI: 1.02; 1.56, p = 0.029), and for monocytes 0.93 (95% CI: 0.68; 1.28, p = 0.67) comparing top to bottom tertile. In cross-sectional studies, RR was 1.74 (95% CI: 1.49; 2.02, p = 7.7*10−13), while in cohort studies it was 1.48 (95% CI: 1.22; 1.79, p = 7.7*10−5). We assessed the impact of confounding in EPIC-Norfolk study and found that the age and sex adjusted HR of 2.19 (95% CI: 1.74; 2.75) was attenuated to 1.82 (95% CI: 1.45; 2.29) after further accounting for smoking, T2D family history, physical activity, education, BMI and waist circumference. A raised WBC is associated with higher risk of T2D. The presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.
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影响因子：
7.7
作者：
Duncan, BB;Schmidt, MI;Heiss, G
通讯作者：
Heiss, G
影响因子：
8.7
作者：
Hak, AE;Stehouwer, CDA;Witteman, JCM
通讯作者：
Witteman, JCM
影响因子：
7.7
作者：
Donath, MY;Ehses, JA;Reinecke, M
通讯作者：
Reinecke, M
DOI：
10.1038/oby.2000.33
发表时间：
2000-07-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Duncan, BB;Schmidt, MI;Heiss, G
通讯作者：
Heiss, G
影响因子：
8.2
作者：
Chien, K.;Cai, T.;Hu, F. B.
通讯作者：
Hu, F. B.