Study On The Relationship Between White Blood Cell And Type 2 Diabetes Mellitus

Objective:To study the relationship between white blood cell (WBC) and type 2 diabetes mellitus (T2DM). To investigate the effect of interaction of leukocytes with waist circumference, triglyceride, hypertension, overweight respectivly on type 2 diabetes mellitus (T2DM).Methods:The examination document and clinic data of 349 elderly people was extracted from 2 township health center and 2 community health service center in Lanshan Districts.182 cases of T2DM patients were selected as observation group,167 patients without T2DM as control group. The height, weight, waist circumference, leukocyte, neutrophil cells, lymphocytes, plasma glucose, urea, creatinine, uric acid, total cholesterol, glycerin three fat, urine protein, urine pH, urine glucose and other indicators were measured. The metric data and the count data were expressed by mean±standard deviation and frequency (%), respectively. Univariate and multiple Logistic regression were applied to analyze the relationship between Type 2 Diabetes Mellitus and white blood cell count. The potential confounding factors and estimated odds ratio (OR) were assessed by multivariate Logistic. The effect of interaction between white blood cells and these factors including waist circumference, triglyceride, hypertension, and overweight, on Type 2 Diabetes Mellitus was analyzed by the additive model.Result:The univariate logistic regression analysis revealed that the risk of diabetes increases by 1.25,1.50 and 1.30 times per unit for the total number of white blood cells, lymphocytes and the number of neutrophils, respectively. When the total number of white blood cells, lymphocytes and neutrophils were categorized by tertiles, then the results also showed significantly positive correlation with T2DM. Multiple logistic regression model was used to adjust the potential confounder including gender, age, hypertension, BMI, waist circumference, urea, creatinine, total cholesterol, glycerin three fat, high density lipoprotein, low density lipoprotein, aspartate aminotransferase, alanine aminotransferase, urine pH, urine protein. The result showed that the risk of diabetes increased by 1.18,1.27 and 1.23 times per unit for the total number of white blood cells, lymphocytes and the number of neutrophils, respectively.When the total number of white blood cells, lymphocytes and neutrophils were divided by tertiles, The results of the risk of T2DM, including OR and 95% confidence limits, are as follows:For white blood cells were:1.52 (0.83-2.80),2.72 (1.42-5.19); for lymphocyte numbers were:1.10 (0.61-1.98),1.45 (0.78-2.71); for neutrophil counts were:1.52 (0.86-2.82),2.13 (1.15-3.95), respectively. Regarding the interaction analyses, the univariate analysis of white blood cell with waist circumference, triglyceride, hypertension and overweight showed that the effect of the two factors combined was greater than that of the two factors separately, so that it indicated that there was a positive additive interaction between the two factors. The synergy index (S) were 1.91, 3.46,1.30,3.61, respectively. The relative risk (RERI) were 2.30,9.31, 1.86,3.41, respectively. And the attributable proportion due to interaction (AP) were 39.48%,,66.03%,59.67%,20.50%, respectively. The potential confounders including gender, age, blood pressure, waist circumference, blood urea, creatinine, total cholesterol, glycerin three greases, high density lipoprotein, low density lipoprotein, aspartate transaminase, glutamic pyruvic transaminase, urinary protein, urinary acid-base degree, were adjusted by multivariate logistic regression. The adjusted interaction were as follows:for waist circumference, triglyceride, hypertension, overweight, respectively, S were 1.76,3.10,1.12,2.73, RERI were 1.55,0.82,6.98,1.08, AP were 33.78%,9.38%,61.74%, 39.89%, respectively.Conclusion:White blood cell count, lymphocyte count, neutrophil count were significantly associated with the risk of T2DM, whether its original value or tertile analysis. The relationship between white blood cells and T2DM was not entirely dependent on other factors. Waist circumference, triglyceride, hypertension and overweight were risk factors of diabetes. The interaction between white blood cells and these factors above-mentioned on risk of diabetes mellitus were additive model. So it increases significantly the risk of T2DM.