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Issue 93 Item 2 White Blood Cell Count Predicts Diabetes

New Tool to Diagnosis possible development of type 2 diabetes and worsening of insulin sensitivity. >A high white blood cell count (WBC) predicts the development of type 2 diabetes, say researchers.

The researchers measured the WBC in 352 nondiabetic Pima Indians (215 men; 137 women) who were characterized by body composition, glucose tolerance, insulin action and acute insulin secretary response. Chronic low-grade inflammation may be involved in the pathogenesis of insulin resistance and type 2 diabetes. We examined whether a high white blood cell count (WBC), a marker of inflammation, predicts a worsening of insulin action, insulin secretory function, and the development of type 2 diabetes in Pima Indians.

Among the 272 individuals with normal glucose tolerance at baseline, 54 developed diabetes over the follow-up. In a multivariate analysis that accounted for age and sex, percentage of body fat and Insulin action was independently associated with WBC.

A high WBC value predicted diabetes (relative hazard 90th vs. 10th percentiles [95%CI] of 2.7 [1.3–5.4], P = 0.007) when adjusted for age and sex. The predictive effect of WBC persisted after additional adjustment for established predictors of diabetes, i.e., percent body fat, M, and AIR (relative hazard 2.6 [1.1–6.2], P = 0.03). After adjustment for follow-up duration, a high WBC at baseline was associated with a subsequent worsening of M (P = 0.003), but not a worsening of AIR. A high WBC predicts a worsening of insulin action and the development of type 2 diabetes in Pima Indians. These findings are consistent with the hypothesis that a chronic activation of the immune system may play a role in the pathogenesis of type 2 diabetes.

Reference: Vozarova B et al. High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002; 51: 455-61