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Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. |
| Publication Type | Journal Article |
| Year of Publication | 2010 |
| Authors | Gkrania-Klotsas, E, Ye, Z, Cooper, AJ, Sharp, SJ, Luben, R, Biggs, ML, Chen, L-K, Gokulakrishnan, K, Hanefeld, M, Ingelsson, E, Lai, W-A, Lin, S-Y, Lind, L, Lohsoonthorn, V, Mohan, V, Muscari, A, Nilsson, G, Ohrvik, J, Qiang, JChao, Jenny, NSwords, Tamakoshi, K, Temelkova-Kurktschiev, T, Wang, Y-Y, Yajnik, CSakerlal, Zoli, M, Khaw, K-T, Forouhi, NG, Wareham, NJ, Langenberg, C |
| Journal | PLoS One |
| Volume | 5 |
| Issue | 10 |
| Pagination | e13405 |
| Date Published | 2010 Oct 18 |
| ISSN | 1932-6203 |
| Keywords | Adult, Aged, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Humans, Leukocyte Count, Male, Middle Aged, Prospective Studies |
| Abstract | <p><b>OBJECTIVE: </b>Biological evidence suggests that inflammation might induce type 2 diabetes (T2D), and epidemiological studies have shown an association between higher white blood cell count (WBC) and T2D. However, the association has not been systematically investigated.</p><p><b>RESEARCH DESIGN AND METHODS: </b>Studies were identified through computer-based and manual searches. Previously unreported studies were sought through correspondence. 20 studies were identified (8,647 T2D cases and 85,040 non-cases). Estimates of the association of WBC with T2D were combined using random effects meta-analysis; sources of heterogeneity as well as presence of publication bias were explored.</p><p><b>RESULTS: </b>The combined relative risk (RR) comparing the top to bottom tertile of the WBC count was 1.61 (95% CI: 1.45; 1.79, p = 1.5*10(-18)). Substantial heterogeneity was present (I(2) = 83%). For granulocytes the RR was 1.38 (95% CI: 1.17; 1.64, p = 1.5*10(-4)), for lymphocytes 1.26 (95% CI: 1.02; 1.56, p = 0.029), and for monocytes 0.93 (95% CI: 0.68; 1.28, p = 0.67) comparing top to bottom tertile. In cross-sectional studies, RR was 1.74 (95% CI: 1.49; 2.02, p = 7.7*10(-13)), while in cohort studies it was 1.48 (95% CI: 1.22; 1.79, p = 7.7*10(-5)). We assessed the impact of confounding in EPIC-Norfolk study and found that the age and sex adjusted HR of 2.19 (95% CI: 1.74; 2.75) was attenuated to 1.82 (95% CI: 1.45; 2.29) after further accounting for smoking, T2D family history, physical activity, education, BMI and waist circumference.</p><p><b>CONCLUSIONS: </b>A raised WBC is associated with higher risk of T2D. The presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.</p> |
| DOI | 10.1371/journal.pone.0013405 |
| Alternate Journal | PLoS ONE |
| PubMed ID | 20976133 |
| PubMed Central ID | PMC2956635 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States R01 HL075366 / HL / NHLBI NIH HHS / United States MC_UP_A100_1003 / / Medical Research Council / United Kingdom R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States T37 TW000049 / TW / FIC NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States R01 HL094555 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States MC_U106179471 / / Medical Research Council / United Kingdom G0701652 / / Medical Research Council / United Kingdom G0401527 / / Medical Research Council / United Kingdom R01 AG020098 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |