Abstract
The association between immunity and metabolic syndrome (MetS) has been studied, but its interaction with lifestyles remains unclear. We studied their association and interactions with lifestyles in 40,768 adults aged over 40 years from a large-scale, hospital-based cohort study collected during 2010–2013. White blood cell counts (WBC) and serum C-reactive protein concentrations (CRP) were used as indexes of immune status. The participants were categorized into four groups by the cutoff points of 6.2 × 109/L WBC(L-WBC) and <0.5 mg/dL CRP(L-CRP): L-WBC+L-CRP(n = 25,604), H-WBC+L-CRP(n = 13,880), L-WBC+H-CRP(n = 464), and H-WBC+H-CRP(n = 820). The participants in the H-WBC+L-CRP were younger and had higher numbers of males than the L-WBC+L-CRP. MetS risk was higher by 1.75- and 1.86-fold in the H-WBC+L-CRP and H-WBC+H-CRP, respectively, than the L-WBC+L-CRP. MetS components, including plasma glucose and triglyceride concentrations, and SBP were elevated in H-WBC+L-CRP and H-WBC+H-CRP compared with L-WBC+L-CR+P. The risk of hyperglycemia and high HbA1c was the highest in the H-WBC+H-CRP among all groups. Areas of WBC counts and serum CRP concentrations were 0.637 and 0.672, respectively, in the receiver operating characteristic curve. Daily intake of energy, carbohydrate, protein, and fat was not significantly different in the groups based on WBC counts and CRP. However, a plant-based diet (PBD), physical activity, and non-smoking were related to lowering WBC counts and CRP, but a Western-style diet was linked to elevating CRP. A high PBD intake and smoking status interacted with immunity to influence MetS risk: a low PBD and current smoking were associated with a higher MetS risk in the H-WBC+H-CRP. In conclusion, overactivated immunity determined by CRP and WBC was associated with MetS risk. Behavior modification with PBD and physical activity might be related to immunity regulation.
Highlights
In the pandemic era, maintaining optimal immunity plays a crucial role in protecting against pathogens
More male subjects belonged to the H-white blood cell (WBC)+L-C-reactive protein (CRP) and H-WBC+H-CRP than the other groups, whereas female participants were more prevalent in the L for white blood cell counts (L-WBC)+L-CRP and L-WBC+HCRP groups
More participants who answered “yes” for regular physical activity belonged to the L-WBC+L-CRP and L-WBC+HCRP groups than those who answered “no” (Table 1)
Summary
In the pandemic era, maintaining optimal immunity plays a crucial role in protecting against pathogens. Chronic metabolic disorders, including type 2 diabetes and obesity, contribute to the chronic activation of innate immune responses that impairs the increase of adaptive immunity when an infection occurs [2]. In modern, industrialized societies, people have chronic, low-grade inflammation due to immune overactivation. It is associated with worsening cardiovascular diseases and autoimmune diseases [3]. Increased WBC counts and serum CRP concentrations indicate overactivated immunity. Immune status is associated with lifestyles, especially nutrient intake and dietary patterns. Mental stress, cigarette smoking, and sedentary life may increase chronic inflammation, an abnormal immune response [5]. We hypothesized that overactivated immunity was associated with MetS risk, and they had interactions with lifestyles, including dietary patterns.
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