Predictive Value Of Peripheral White Blood Cell Counts Within Normal Range On Type 2 Diabetes

Chapter 1 Predictive value of peripheral white blood cell counts within normal range on type 2 diabetesObjective:To assess the predictive value of peripheral white blood cell counts(WBC)within normal range on type 2 diabetes.Methods:4067 individuals were evaluated for routine health examination in People's Hospital of Human province from June 2006 to January 2010.Among them,1358 were followed up.In 398 cases who were checked up once a year,397 had normal WBC.Data were collected including body height,body weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL),fast blood glucose(FBG),serum alanine aminotransferase(ALT),serum uric acid(UA)and peripheral white blood cell count(WBC).Analyze the risk factors of type 2 diabetes by logistic regression.Receiver operator curve(ROC)was made for predictive value of WBC while using the incidence of type 2 diabetes as state variable and baseline WBC as test variable.All individuals with normal WBC were divided into 4 quartile groups.Compare the risk of type 2 diabetes between different groups.Results:1.The risk factors of type 2 diabetes were AGE,TG,FBS and WBC.2.ROC curve for the diagnosis value of WBC on type 2 diabetes:the area under curve was 0.619(95%CI,0.531-0.707,P<0.05),and the sensitivity was 0.882,specificity was 0.364,Youden's index was 0.246.3.Among the different quartile groups of WBC in normal range,the upper quartile group had the highest risk of type 2 diabetes(OR 4.486,P<0.05).Conclusions:The elevation of WBC within normal range may help to predict type 2 diabetes.Chapter 2 Predictive value of peripheral white blood cell counts on type 2 diabetes in people with different BMI and metabolic statusObjective:Predictive value of peripheral white blood cell counts on type 2 diabetes in people with different BMI and metabolic status.Methods:Data collection was the same as chapter 1.Obesity was defined as BMI?25kg/m2 according to the diagnostic criteria of International obesity task force(IOTF)on Asian-pacific region in 2000.Metabolic syndrome(MS)was diagnosed by the criteria of American National Cholesterol Education Program(NCEP)Adult Treatment Panel III(ATP-III).Compare the risk of type 2 diabetes in different groups with or without obesity and MS.Analyze the risk of type 2 diabetes in the above groups when WBC was increased.Results:1.After 4-year follow-up,obese group had higher risk of abnormal glucose metabolism than non-obese people(OR 1.773,P<0.05).MS had higher risk of type 2 diabetes than non-MS(OR 12.91,P<0.05)ones.2.MS with or without obesity both had higher risk of type 2 diabetes than normal controls(OR 30.656,61.489,P<0.05).Those obese ones without MS also had elevated risk of type 2 diabetes(OR 8.608,P<0.05).3.Obesity whether was higher WBC or lower WBC both has higher risk of abnormal glucose metabolism than normal controls,(OR 2.469,2.248,P<0.05).Those without obesity but higher WBC also has higher risk of abnormal glucose metabolism(OR 1.667,P<0.05).4.MS whether was higher WBC or lower WBC both has higher risk of type 2 diabetes than normal controls(OR 20.324,15.059,P<0.05).Those without MS but higher WBC of the risk of the type 2 diabetes has no significant increase.Conclusions:Obesity compared with without obesity,showed higher risk of type 2 diabetes.Those with MS compared with without MS,showed higher the risk of type 2 diabetes.WBC can be another maker to predict the occurrence of type 2 diabetes besides obesity and MS.Chapter 3 Establish prediction model for type 2 diabetes by combining with obesity,MS and WBCObjective:Establish prediction model for type 2 diabetes by combining with obesity,MS and WBC.Methods:Data collection was the same as chapter 1.Diagnostic criteria was the same as chapter 2.Establish a model to predict type 2 diabetes using obesity,MS and WBC,and analyze different risk of type 2 diabetes those with differences groups of obesity,MS and WBC.A means obesity or not,A+ means obesity,A-means without obesity,B means MS or not,B+ means MS,B-means without MS,C means WBC,C+means higher WBC within the normal range,C-means lower WBC within the normal range.Results:1.After follow-up of 4 years,compared with A-B-C-group,A-B+C+ and A-B+C-has the highest risk of type 2 diabetes(OR 50.63,47.90,P<0.05).2.In two groups of A+B+,C+ has higher risk of type 2 diabetes than C-,(OR 35.53,19.29,P<0.05).3.In two groups of A+B-,C+ has higher risk of type 2 diabetes than C-,(OR 13.50,4.57,P>0.05).Conclusions:1.The highest risk of the occurrence of type 2 diabetes in those with MS but without obesity,whether the WBC elevate or not.2.Obesity people with MS has higher risk of type 2 diabetes than in those without obesity with MS,and in those WBC has higher risk.3.Obesity people without MS has higher risk of type 2 diabetes in elevated WBC group but not in those with lower WBC.4.WBC can be used to distinguish those with higher risk of type 2 diabetes in obesity but normal metabolism and obesity with MS.But in those without obesity is hard to distinguish those with higher risk of type 2 diabetes whether metabolism was normal or not.