The Association Between White Blood Cell Count and Insulin Resistance in Community-Dwelling Middle-Aged and Older Populations in Taiwan: A Community-Based Cross-Sectional Study.

Jau-Yuan Chen,Yu-Chien Lee,Yun-Hung Chen,Meng-Ting Tsou

doi:10.3389/fmed.2022.813222

Abstract

BackgroundInsulin resistance (IR) is a major pathophysiological factor in the development and progression of diabetes mellitus (DM). DM is highly prevalent in Taiwan and has become one of the most common health problems in family medicine and primary care. We aimed to use white blood cell count (WBC), a common physiological parameter, to develop a simple clinical prediction rule for IR in the middle-aged and old Taiwanese population.MethodsIn this cross-sectional community-based study, the participants completed a questionnaire comprising personal and medical history data and underwent anthropometric measurements and blood sampling. IR was defined as a HOMA-IR index ≥2. Independent t-test, Mann–Whitney U test, chi-square test, Pearson's correlation test, multivariate binary logistic regression, and receiver operating characteristic curves were used to evaluate the association between the WBC count and IR.ResultsA total of 398 community-dwelling middle-aged and older persons (34.9% men) with a mean age of 64.43 ± 8.45 years were enrolled for the analysis. A significant association was identified between the WBC counts and IR, with a Pearson's correlation coefficient of 0.37 (p-value <0.001). Multivariate logistic regression revealed that WBC count (OR = 1.50; 95% CI = 1.25–1.81) was an independent risk factor for IR after adjusting for confounding variables. The area under the receiver operating characteristic curve for WBC count was 0.67, and the optimal threshold value was 5.65 1,000/uL.ConclusionA high WBC count is positively related to an increased risk of IR among middle-aged and older people in Taiwan.

Highlights

Insulin resistance (IR) is recognized as a serious public health problem worldwide and has emerged as a major pathophysiological factor in the development and progression of type 2 diabetes mellitus (T2DM) and metabolic disease (1–4)
A significant association was identified between the white blood cell count (WBC) counts and IR, with a Pearson’s correlation coefficient of 0.37 (p-value < 0.001)
Multivariate logistic regression revealed that WBC count (OR = 1.50; 95% CI = 1.25–1.81) was an independent risk factor for IR after adjusting for confounding variables

Summary

Introduction

Insulin resistance (IR) is recognized as a serious public health problem worldwide and has emerged as a major pathophysiological factor in the development and progression of type 2 diabetes mellitus (T2DM) and metabolic disease (1–4). The hyperinsulinemic euglycemic clamp test, the gold standard for assessing IR, has been used to quantify IR using a variety of methods. This test is expensive, invasive, and time-consuming, making it unsuitable for clinical purposes or large-scale studies (5). As IR is a risk factor for the development of T2DM, the early identification of IR is important from a public health perspective. In clinical practice, evaluating IR using the HOMA-IR index is often difficult as insulin and fasting glucose levels are not routinely measured. We aimed to use white blood cell count (WBC), a common physiological parameter, to develop a simple clinical prediction rule for IR in the middle-aged and old Taiwanese population

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