WBC counts in diabetes risk prediction

By Sally Robertson, B.Sc.Oct 1 2012

An elevated white blood cell (WBC) count in young men is an independent predictor for the development of diabetes in later life, suggest study findings.

In addition, overweight and obese individuals with a relatively low WBC count have a significantly lower risk for diabetes than those with a higher count.

"This may help in better characterizing obese individuals who are relatively protected from the metabolic derangements frequently associated with obesity," say Amir Tirosh (Harvard Medical School, Boston, Massachusetts, USA) and colleagues.

Previous studies have been inconsistent in whether WBC or other inflammatory markers contribute to diabetes prediction models independently of obesity or whether these markers simply reflect adipose tissue mass, explain the researchers.

In their study of 24,897 normoglycemic men, aged a mean of 30.8 years, and with a WBC range of 3000 to 12,000 cells/mm³, there were 447 cases of incident diabetes over a mean follow-up period of 7.7 years.

The incidence of Type 2 diabetes increased linearly across quintiles, with 62 new cases diagnosed in the lowest quintile (WBC 3000-5400 cells/mm³) and 124 incident cases in the highest quintile (WBC >7810 cells/mm³).

As reported in Diabetes Care, each increase of 1000 cells/mm³ in WBC count was associated with a 7.6% increase in risk for developing diabetes, at a hazard ratio (HR) of 1.08, after adjusting for age, body mass index (BMI), family history of diabetes, physical activity, triglyceride level, and fasting plasma glucose.

The team reports that men with obesity (BMI =30 kg/m²) who were in the highest quintile for WBC had a more than sixfold increase in the risk for diabetes compared with obese men in the lowest quintile.

Interestingly, men in the lowest WBC quartile were at a significantly decreased risk for diabetes compared with those in the highest quintile, even in the presence of overweight/obesity, a family history of diabetes, or elevated triglyceride levels.

"These observations suggest that, in the presence of a low-normal WBC count, overweight and obese men are relatively protected from the development of type 2 diabetes compared with overweight or obese individuals with higher WBC count," say Tirosh et al.

"Targeting the obesity-related chronic inflammatory response to prevent the metabolic derangements associated with increased fat deposition may become an attractive approach for diabetes prevention once additional, more specific anti-inflammatory treatments with more tolerated side effects become available," concludes the team.

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