Abstract
Objectives:
Epidemiological studies have revealed an association between higher total
peripheral white blood cells (WBC) count and Type 2 Diabetes Mellitus (T2DM).
However, the association has not been systematically investigated. The aim of
this study was to compare peripheral leukocyte count and biochemical test
results in diabetic and non–diabetic patients.
Materials and Methods: The study was
conducted among the patients had been followed by Family Medicine Outpatient
Clinics of Dışkapı Yıldırım Beyazıt Training and Research Hospital between
02.02.2015-30.09.2015. Patients anthropometric measurements, complete blood
cell count and biochemical tests’ results were recorded and these values were
compared between two groups (T2DM(+) and T2DM(-)).
Results: A total of 286 patients
(mean age: 58.7±10.5 years) were enrolled. There were no differences in age and
sex distribution between T2DM(+) (n=108) and T2DM (-) (n=178) groups. In
T2DM(+) group, leukocyte count was found to be higher than T2DM(-) group (7.73
× 103/ml; 7.17 × 103/ml; p=0.001). Waist circumference, body mass index,
fasting blood glucose, alanine amino transferase and triglycerides levels were
also found to significantly higher in T2DM(+) group. Conversly, high density
lipoprotein and low-density lipoprotein levels were found to be significantly
lower in T2DM(+) group.
Conclusion: Leukocyte count, even
within normal range, was higher in T2DM patients compared to non-diabetic
individuals. Our results support the role of chronic inflammation in T2DM.
There is a need for comprehensive studies to explain the role of inflammation
in diabetes.
Keywords
References
- 1. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001;286(3):327–34.
- 2. Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol 2011;11(2):98–107.
- 3. Odegaard Jl, Chawla A. PleiotropicActions of Insulin Resistance and Inflammation in Metabolic Homeostasis. Science 2013;339(6116):172-7.
- 4. Gkrania-Klotsas E, Ye Z, Cooper AJ, et al. Differential White blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PloSone 2010;5(10):13405.
- 5. Kılıçlı MF, Acıbucu F. Chronic Inflammation, Insulin Resistance and Diabetes. Turkiye Klinikleri J Pharmacol- Special Topics 2015;3(3):30-5.
- 6. Yudkin JS, Juhan-Vague I, Hawe E, et al. Low grade inflammation may play a role in the etiology of metabolic syndrome in patients with coronary heart disease: HIFMECH study. Metabolism 2004;53:852–7.
- 7. Schmidt MI, Duncan BB, Sharrett AR, et al. Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study. Lancet 1999;353(9165):1649–52.
- 8. Nilsson J, Jovinge S, Niemann A, Reneland R, Lithell H. Relation between plasma tumor necrosis factor-alpha and insülin sensitivity in elderly men with non-insulin-dependent diabetes mellitus. Arteriosclerosis, thrombosis, and vascular biology 1998;18(8):1199–202.
- 9. Muller-Steinhardt M, Ebel B, Hartel C. The impact of interleukin-6 promoter -597/-572/-174 genotype on interleukin-6 production after lipopolysaccharide stimulation. Clin Experiment Immunol 2007;147(2):339–45.
- 10. Senn JJ, Klover PJ, Nowak IA, Mooney RA. Interleukin-6 induces cellular insülin resistance in hepatocytes. Diabetes 2002;51(12):3391–9.
- 11. Borné Y, Smith JG, Nilsson PM, Melander O, Hedblad B, Engström G. Total and Differential Leukocyte Counts in Relation to Incidence of Diabetes Mellitus: A Prospective Population-Based Cohort Study. PLoS One 2016;11(2):e0148963.
- 12. Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol 2011;29:415–45.
- 13. Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS. Protection from obesity-induced insülin resistance in mice lacking TNF-alpha function. Nature 1997;389:610–4.
- 14. Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: associations with obesity, insülin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999;19(4):972–8.
- 15. Mohamed-Ali V, Goodrick S, Rawesh A, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab 1997;82(12):4196–200.
- 16. Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006;444:860–7.
- 17. Das A, Mukhopadhyay S. The evil axis of obesity, inflammation and type-2 diabetes. Endocr Metab Immune Disord Drug Targets 2011;11(1):23-31.
- 18. Pitsavos C, Tampourlou M, Panagiotakos DB, et al. Association between low-grade systemic inflammation and type 2 diabetes mellitus among men and women from the ATTICA study. Rev Diabet Stud 2007;4(2):98–104.
- 19. Duncan BB, Schmidt MI, Pankow JS, et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003;52(7):1799–805.
- 20. Fritsche A, Haring H, Stumvoll M. White blood cell count as a predictor of glucose tolerance and insülin sensitivity. The role of inflammation in the pathogenesis of type 2 diabetes mellitus. Deutsche Medizinische Wochenschrift (1946) 2004;129(6):244–8.
- 21. Vozarova B, Weyer C, Lindsay R.S, Pratley R.E, Bogardus C,Tataranni PA. High White blood cell count is associated with a worsening of insülin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002;51(2):455–61.
- 22. Gokulakrishnan K, Deepa R, Sampathkumar R, Balasubramanyam M, Mohan V. Association of leukocyte count with varying degrees of glucose intolerance in Asian Indians: The Chennai Urban Rural Epidemiology Study (CURES-26). Metab Syndr Relat Disord 2009;7(3):205–10.
- 23. Nakanishi N, Yoshida H, Matsuo Y, Suzuki K, Tatara K. White blood-cell count and the risk of impaired fasting glucose or type II diabetes in middle-aged Japanese men. Diabetologia 2002;45(1):42–8.
- 24. Manolio TA, Burke GL, Psaty BM et al. Black-white differences in subclinical cardiovascular disease among older adults: The cardiovascular health study. Journal of Clinical Epidemiology 1995;48(9):1141-52.
- 25. Hua J, Wen-Hua Y, Chan-Juan L, An-Ping W, Jing-Tao D, Yi-Ming M. Elevated White Blood Cell Count is Associated with Higher Risk of Glucose Metabolism Disorders in Middle-Aged and Elderly Chinese People. Int J Environ Res Public Health 2014;11(5):5497–509.
- 26. Twig G, Afek A, Shamiss A et al. White blood cells count and incidence of type 2 diabetes in young men. Diabetes Care 2013;36(2):276–82.
- 27. Khovidhunkit W, Kim MS, Memon RA et al. Effects of infection and inflammation on lipid and lipoprotein metabolism: Mechanisms and consequences to the host. J Lipid Res 2004;45(7):1169–96.
- 28. Boucher A.A, Edeoga C, Ebenibo S, Wan J, Dagogo-Jack S. Leukocyte Count and cardiometabolic risk among healthy participants with parental type 2 diabetes: The pathobiology of prediabetes in a biracial cohort study. Ethn Dis 2012;22(4):445–50.
- 29. Oda E, Kawai R, Aizawa Y. Lymphocyte count was significantly associated with hyper-LDL cholesterolemia independently of high-sensitivity Creactive protein in apparently healthy Japanese. Heart Vessels 2012;27(4):377–83.
Abstract
Amaç: Epidemiyolojik
araştırmalar periferik kandaki lökosit sayısı ile Tip 2 Diyabetes Mellitus
(T2DM) arasında ilişki bulunduğunu göstermesine rağmen bu ilişki sistematik
olarak incelenmemiştir. Bu çalışmada, T2DM tanısı olan hastaların (T2DM(+))
lökosit sayımı ve biyokimya tetkik sonuçlarının diyabeti olmayan hastaların
(T2DM(-)) sonuçlarıyla karşılaştırılması amaçlanmıştır.
Materyal ve Metot: Çalışmaya;
02.02.2015-30.09.2015 tarihleri arasında Dışkapı Yıldırım Beyazıt Eğitim ve
Araştırma Hastanesi Aile Hekimliği Poliklinikleri’ne başvuran hastalar
alınmıştır. Hastaların antropometrik ölçümleri, tam kan sayımı ve biyokimyasal
testlerinin sonuçları kaydedilmiştir ve bu değerler T2DM(+) ile T2DM(-)
grupları arasında karşılaştırılmıştır.
Bulgular: Çalışmaya dâhil
edilen 286 hastanın yaş ortalaması 58,7±10,5 yıl olarak saptandı. T2DM(+)
(n=108) ve T2DM(-) (n=178) gruplarının yaş ve cinsiyet dağılımları arasında
fark yoktu. T2DM(+) grubun ortalama lökosit sayısının T2DM(-) grubundan yüksek
olduğu saptandı (7,73 × 103/ml; 7,17 × 103/ml; p=0,001). T2DM(+) grubun bel
çevresi, vücut kitle indeksi (VKİ), açlık kan şekeri (AKŞ), alanin
aminotransferaz (ALT) ve trigliserid değerleri T2DM(-) grubuna göre anlamlı
olarak yüksek olduğu, düşük yoğunluklu kolesterol (LDL) ve yüksek yoğunluklu
kolesterol (HDL) değerlerinin ise anlamlı olarak daha düşük olduğu
bulundu.
Sonuç: Lökosit sayısı normal
sınırlar içerisinde dahi T2DM hastalarında diyabeti olmayan bireylerden daha
yüksektir. Bizim sonuçlarımız kronik inflamasyonun Tip 2 diyabetteki rolünü
desteklemektedir. İnflamasyonun diyabetteki rolünü açıklayacak daha kapsamlı
çalışmalara ihtiyaç vardır.
Keywords
References
- 1. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001;286(3):327–34.
- 2. Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol 2011;11(2):98–107.
- 3. Odegaard Jl, Chawla A. PleiotropicActions of Insulin Resistance and Inflammation in Metabolic Homeostasis. Science 2013;339(6116):172-7.
- 4. Gkrania-Klotsas E, Ye Z, Cooper AJ, et al. Differential White blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PloSone 2010;5(10):13405.
- 5. Kılıçlı MF, Acıbucu F. Chronic Inflammation, Insulin Resistance and Diabetes. Turkiye Klinikleri J Pharmacol- Special Topics 2015;3(3):30-5.
- 6. Yudkin JS, Juhan-Vague I, Hawe E, et al. Low grade inflammation may play a role in the etiology of metabolic syndrome in patients with coronary heart disease: HIFMECH study. Metabolism 2004;53:852–7.
- 7. Schmidt MI, Duncan BB, Sharrett AR, et al. Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study. Lancet 1999;353(9165):1649–52.
- 8. Nilsson J, Jovinge S, Niemann A, Reneland R, Lithell H. Relation between plasma tumor necrosis factor-alpha and insülin sensitivity in elderly men with non-insulin-dependent diabetes mellitus. Arteriosclerosis, thrombosis, and vascular biology 1998;18(8):1199–202.
- 9. Muller-Steinhardt M, Ebel B, Hartel C. The impact of interleukin-6 promoter -597/-572/-174 genotype on interleukin-6 production after lipopolysaccharide stimulation. Clin Experiment Immunol 2007;147(2):339–45.
- 10. Senn JJ, Klover PJ, Nowak IA, Mooney RA. Interleukin-6 induces cellular insülin resistance in hepatocytes. Diabetes 2002;51(12):3391–9.
- 11. Borné Y, Smith JG, Nilsson PM, Melander O, Hedblad B, Engström G. Total and Differential Leukocyte Counts in Relation to Incidence of Diabetes Mellitus: A Prospective Population-Based Cohort Study. PLoS One 2016;11(2):e0148963.
- 12. Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol 2011;29:415–45.
- 13. Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS. Protection from obesity-induced insülin resistance in mice lacking TNF-alpha function. Nature 1997;389:610–4.
- 14. Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: associations with obesity, insülin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999;19(4):972–8.
- 15. Mohamed-Ali V, Goodrick S, Rawesh A, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab 1997;82(12):4196–200.
- 16. Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006;444:860–7.
- 17. Das A, Mukhopadhyay S. The evil axis of obesity, inflammation and type-2 diabetes. Endocr Metab Immune Disord Drug Targets 2011;11(1):23-31.
- 18. Pitsavos C, Tampourlou M, Panagiotakos DB, et al. Association between low-grade systemic inflammation and type 2 diabetes mellitus among men and women from the ATTICA study. Rev Diabet Stud 2007;4(2):98–104.
- 19. Duncan BB, Schmidt MI, Pankow JS, et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003;52(7):1799–805.
- 20. Fritsche A, Haring H, Stumvoll M. White blood cell count as a predictor of glucose tolerance and insülin sensitivity. The role of inflammation in the pathogenesis of type 2 diabetes mellitus. Deutsche Medizinische Wochenschrift (1946) 2004;129(6):244–8.
- 21. Vozarova B, Weyer C, Lindsay R.S, Pratley R.E, Bogardus C,Tataranni PA. High White blood cell count is associated with a worsening of insülin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002;51(2):455–61.
- 22. Gokulakrishnan K, Deepa R, Sampathkumar R, Balasubramanyam M, Mohan V. Association of leukocyte count with varying degrees of glucose intolerance in Asian Indians: The Chennai Urban Rural Epidemiology Study (CURES-26). Metab Syndr Relat Disord 2009;7(3):205–10.
- 23. Nakanishi N, Yoshida H, Matsuo Y, Suzuki K, Tatara K. White blood-cell count and the risk of impaired fasting glucose or type II diabetes in middle-aged Japanese men. Diabetologia 2002;45(1):42–8.
- 24. Manolio TA, Burke GL, Psaty BM et al. Black-white differences in subclinical cardiovascular disease among older adults: The cardiovascular health study. Journal of Clinical Epidemiology 1995;48(9):1141-52.
- 25. Hua J, Wen-Hua Y, Chan-Juan L, An-Ping W, Jing-Tao D, Yi-Ming M. Elevated White Blood Cell Count is Associated with Higher Risk of Glucose Metabolism Disorders in Middle-Aged and Elderly Chinese People. Int J Environ Res Public Health 2014;11(5):5497–509.
- 26. Twig G, Afek A, Shamiss A et al. White blood cells count and incidence of type 2 diabetes in young men. Diabetes Care 2013;36(2):276–82.
- 27. Khovidhunkit W, Kim MS, Memon RA et al. Effects of infection and inflammation on lipid and lipoprotein metabolism: Mechanisms and consequences to the host. J Lipid Res 2004;45(7):1169–96.
- 28. Boucher A.A, Edeoga C, Ebenibo S, Wan J, Dagogo-Jack S. Leukocyte Count and cardiometabolic risk among healthy participants with parental type 2 diabetes: The pathobiology of prediabetes in a biracial cohort study. Ethn Dis 2012;22(4):445–50.
- 29. Oda E, Kawai R, Aizawa Y. Lymphocyte count was significantly associated with hyper-LDL cholesterolemia independently of high-sensitivity Creactive protein in apparently healthy Japanese. Heart Vessels 2012;27(4):377–83.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 20, 2017 |
| Published in Issue | Year 2017 Volume: 17 Issue: 4 |