Abstract
BackgroundThe Metabolic Syndrome (MetS) is a cluster of metabolic abnormalities that includes hyperglucemia, hypertension, dyslipidemia and central obesity, conferring an increased risk of cardiovascular disease. The white blood cell (WBC) count has been proposed as a marker for predicting cardiovascular risk. However, few prospective studies have evaluated the relationship between WBC subtypes and risk of MetS.MethodsParticipants were recruited from seven PREDIMED study centers. Both a baseline cross-sectional (n = 4,377) and a prospective assessment (n = 1,637) were performed. Participants with MetS at baseline were excluded from the longitudinal analysis. The median follow-up was 3.9 years. Anthropometric measurements, blood pressure, fasting glucose, lipid profile and WBC counts were assessed at baseline and yearly during the follow-up. Participants were categorized by baseline WBC and its subtype count quartiles. Adjusted logistic regression models were fitted to assess the risk of MetS and its components.ResultsOf the 4,377 participants, 62.6% had MetS at baseline. Compared to the participants in the lowest baseline sex-adjusted quartile of WBC counts, those in the upper quartile showed an increased risk of having MetS (OR, 2.47; 95%CI, 2.03–2.99; P-trend<0.001). This association was also observed for all WBC subtypes, except for basophils. Compared to participants in the lowest quartile, those in the top quartile of leukocyte, neutrophil and lymphocyte count had an increased risk of MetS incidence. Leukocyte and neutrophil count were found to be strongly associated with the MetS components hypertriglyceridemia and low HDL-cholesterol. Likewise, lymphocyte counts were found to be associated with the incidence of the MetS components low HDL-cholesterol and high fasting glucose. An increase in the total WBC during the follow-up was also associated with an increased risk of MetS.ConclusionsTotal WBC counts, and some subtypes, were positively associated with MetS as well as hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, all components of MetS.Trial registrationControlled-Trials.comISRCTN35739639.
Highlights
In recent years, the prevalence of metabolic syndrome (MetS) has increased dramatically in both developed and developing countries
Metabolic Syndrome (MetS) is a constellation of cardiovascular risk factors strongly associated with type 2 diabetes, cardiovascular diseases, and other chronic conditions, all of which increase the risk of mortality [1,2]
The assessment of the association between the white blood cell (WBC) count and the development of the MetS may help to a better understanding of the pathophysiology of the MetS because chronic subclinical inflammation has been implicated in the genesis of MetS, [10,11] and the leukocyte count may be seen as an inflammation marker that is related to this condition
Summary
The prevalence of metabolic syndrome (MetS) has increased dramatically in both developed and developing countries. MetS is a constellation of cardiovascular risk factors (impaired glucose tolerance, hypertension, dyslipidemia and central obesity) strongly associated with type 2 diabetes, cardiovascular diseases, and other chronic conditions, all of which increase the risk of mortality [1,2]. Early identification of the subjects who are at high risk of developing MetS may help prevent associated cardiovascular events. The leukocyte count has been proposed as an emerging biomarker for predicting future cardiovascular events [7,8] and mortality [9]. The Metabolic Syndrome (MetS) is a cluster of metabolic abnormalities that includes hyperglucemia, hypertension, dyslipidemia and central obesity, conferring an increased risk of cardiovascular disease. The white blood cell (WBC) count has been proposed as a marker for predicting cardiovascular risk. Few prospective studies have evaluated the relationship between WBC subtypes and risk of MetS
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