Abstract P023: Leukocyte Count, Adiposity And Incident Diabetes In A Biracial Cohort

Abstract

Background: Diabetes is one the costliest diseases in the U.S, and excess inflammation associates with greater diabetes risk. Greater adiposity is associated with higher leukocyte count, but the interrelations of body size phenotype, leukocytes, and incident diabetes is unknown. Hypothesis: Body size phenotype and incident diabetes can be further understood using leukocyte count in Black and White people. Methods: The study included 8075 Black and White participants without diabetes at baseline (2003-2007) in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Body size phenotypes included metabolically healthy non-obese, metabolically healthy obese, metabolically unhealthy non-obese, and metabolically unhealthy obese. The interaction of leukocyte count with body size phenotype was assessed. As an exploratory analysis, data were further stratified by race. Results: The interaction of leukocyte count with body size phenotype was significant (p=0.02). In metabolically healthy individuals with or without obesity, the risk of diabetes increased across leukocyte quartiles. In healthy non-obese individuals, the risk of diabetes was 3 times higher in the top compared to the bottom quartile of leukocyte count and 4.5 times higher in unhealthy obese individuals. In contrast, there was no association in metabolically unhealthy participants with or without obesity. Considering race differences, in metabolically healthy non-obese persons, the association was 4 times higher for Black individuals and 2 times higher among White individuals. In the healthy obese group, these associations was larger in White than Black people. Conclusions: Higher leukocyte count is associated with the risk of diabetes in metabolically healthy individuals with or without obesity, but not among metabolically unhealthy individuals. Inflammation, as assessed by leukocyte count, does not identify added risk among those who are already classified as metabolically unhealthy.