Association of total and differential count of leucocytes with type two diabetes among physical examinees in Beijing
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摘要:
目的 探讨北京市体检人群白细胞及其分类计数与2型糖尿病患病的关系,为2型糖尿病的早期诊断和预防提供理论依据。 方法 采用立意抽样方法抽取北京市体检中心2016年1 — 12月参加健康体检的16 855名体检人群作为研究对象,根据2型糖尿病诊断标准将其分为糖尿病和非糖尿病2组,采用多因素非条件logistic回归模型分析白细胞及其分类计数水平对2型糖尿病患病风险的影响。 结果 糖尿病组患者白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数、嗜酸性粒细胞计数和嗜碱性粒细胞计数中位数分别为6.91 × 109/L、4.13 × 109/L、2.18 × 109/L、0.37 × 109/L、0.13 × 109/L和0.03 × 109/L,均高于非糖尿病人群的6.14 × 109/L、3.50 × 109/L、2.09 × 109/L、0.33 × 109/L、0.10 × 109/L和0.02 × 109/L,差异均有统计学意义(均P < 0.001)。在控制了年龄、腰围、总胆固醇水平、吸烟情况、饮酒情况和是否患高血压等混杂因素后,多因素非条件logistic回归分析结果显示,男性白细胞计数5.50 × 109/L~6.39 × 109/L、 > 7.49 × 109和中性粒细胞计数 > 2.96 × 109/L是2型糖尿病患病的危险因素;女性白细胞计数 > 5.10 × 109/L、中性粒细胞计数 > 2.74 × 109/L、淋巴细胞计数 > 2.39 × 109/L、单核细胞计数 > 0.37 × 109/L和嗜酸性粒细胞计数 > 0.14 × 109/L是2型糖尿病患病的危险因素。 结论 白细胞计数和中性粒细胞计数与2型糖尿病患病是2型糖尿病患病的危险因素,而淋巴细胞计数、单核细胞计数和嗜酸性粒细胞计数与2型糖尿病的关系具有性别特异性。 Abstract:Objective To explore the association between total and differential count of leucocytes with type 2 diabetes mellitus (T2DM) among physical examinees in Beijing and to provide a theoretical basis for early diagnosis and prevention of T2DM. Methods We recruited a total of 16 855 health examinees at Beijing Physical Examination Center from January through December 2016 with purpose sampling and assigned them into a T2DM and non-T2DM group according to the diagnosis criteria of T2DM. We performed unconditional multivariate logistic regression to assess the influence of total and differential count of leucocytes on risk of T2DM. Results Higher average counts were detected in T2DM group than in non-T2DM group for total leucocytes (6.91 × 109/L vs. 6.14 × 109/L), neutrophils (4.13 × 109/L vs. 3.50 × 109/L), lymphocytes (2.18 × 109/L vs. 2.09 × 109/L), monocytes (0.37 × 109/L vs. 0.33 × 109/L), eosnophils (0.13 × 109/L vs. 0.10 × 109/L), and basophils (0.03 × 109/L vs. 0.02 × 109/L) (P < 0.05 for all). After adjusting for age, waist circumference, total cholesterol, smoking, alcohol consumption, and hypertension, the results of unconditional multivariate logistic regression analyses demonstrated that risk factors of T2DM included a total leucocyte count of 5.50 × 109/L – 6.39 × 109/L and greater than 7.49 × 109/L and a neutrophil count greater than 2.96 × 109/L for the male participants; while a total leucocyte count greater than 5.10 × 109/L, neutrophil count greater than 2.74 × 109/L, lymphocyte count greater than 2.39 × 109/L, monocyte count greater than 0.37 × 109/L, and eosnophil count greater than 0.14 × 109/L were risk factors of T2DM for the female participants. Conclusion Blood leucocyte and neutrophil count associate with the risk of type 2 diabetes mellitus and the associations of lymphocyte, monocyte, and eosinophil count with type 2 diabetes mellitus risk are gender specific among adult health examinees. -
表 1 不同组别人群一般情况计数资料比较
项目 糖尿病组(n = 775) 非糖尿病组(n = 15 765) χ2值 P值 例数 % 人数 % 性别 男性 564 72.77 8 281 52.53 121.709 < 0.001 女性 211 27.23 7 484 47.47 吸烟 否 522 67.35 12 866 81.61 97.330 < 0.001 是 253 32.65 2 899 18.39 饮酒 否 381 49.16 9 404 59.65 33.642 < 0.001 是 394 50.84 6 361 40.35 高血压 否 381 49.16 11 877 75.34 263.808 < 0.001 是 394 50.84 3 888 24.66 表 2 不同组别人群一般情况计量资料[M(QL~QU)]比较
项目 糖尿病组(n = 775) 非糖尿病组(n = 15 765) Z值 P值 年龄(岁) 54(47~61) 38(31~48) 27.587 < 0.001 腰围(cm) 90(86~97) 80(72~89) 23.340 < 0.001 总胆固醇(mmol/L) 4.98(4.31~5.77) 4.67(4.11~5.28) 8.550 < 0.001 白细胞计数(× 109/L) 6.91(5.90~8.20) 6.14(5.26~7.20) 13.639 < 0.001 中性粒细胞计数(× 109/L) 4.13(3.38~4.98) 3.50(2.85~4.30) 13.941 < 0.001 淋巴细胞计数(× 109/L) 2.18(1.81~2.62) 2.09(1.75~2.48) 4.604 < 0.001 单核细胞计数(× 109/L) 0.37(0.30~0.45) 0.33(0.26~0.40) 9.860 < 0.001 嗜酸性粒细胞计数(× 109/L) 0.13(0.08~0.20) 0.10(0.06~0.17) 6.888 < 0.001 嗜碱性粒细胞计数(× 109/L) 0.03(0.02~0.04) 0.02(0.01~0.04) 5.487 < 0.001 表 3 北京市体检人群白细胞及其分类计数与2型糖尿病患病关系多因素非条件logistic回归分析
性别 因素 参照组 β $S_{\overline x}$ wald χ2值 P值 OR值 95 % CI 男性 白细胞计数(× 109/L) 5.501~6.390 ≤ 5.500 0.402 0.166 5.887 0.015 1.495 1.080~2.069 6.391~7.490 0.310 0.169 3.348 0.067 1.363 0.978~1.901 > 7.490 0.643 0.160 16.257 < 0.001 1.903 1.392~2.602 中性粒细胞计数(× 109/L) 2.961~3.610 ≤ 2.960 0.368 0.164 5.019 0.025 1.445 1.047~1.993 3.611~4.430 0.486 0.158 9.418 0.002 1.626 1.192~2.218 > 4.430 0.859 0.154 31.123 < 0.001 2.360 1.746~3.192 淋巴细胞计数(× 109/L) 1.801~2.150 ≤ 1.800 0.082 0.134 0.371 0.542 1.085 0.835~1.410 2.151~2.560 0.013 0.138 0.009 0.925 1.013 0.773~1.328 > 2.560 – 0.022 0.139 0.025 0.874 0.978 0.745~1.284 单核细胞计数(× 109/L) 0.291~0.350 ≤ 0.290 0.115 0.143 0.648 0.421 1.122 0.848~1.484 0.351~0.440 0.211 0.144 2.133 0.144 1.235 0.930~1.639 > 0.440 0.184 0.146 1.596 0.207 1.202 0.904~1.599 嗜酸性粒细胞计数(× 109/L) 0.071~0.110 ≤ 0.070 0.032 0.142 0.051 0.822 1.032 0.782~1.362 0.111~0.200 – 0.032 0.149 0.046 0.830 0.969 0.723~1.298 > 0.200 – 0.202 0.150 1.803 0.179 0.817 0.609~1.097 嗜碱性粒细胞计数(× 109/L) 0.011~0.020 ≤ 0.010 – 0.151 0.238 0.403 0.526 0.860 0.539~1.371 0.021~0.040 – 0.102 0.262 0.152 0.697 0.903 0.540~1.510 > 0.040 0.008 0.252 0.001 0.976 1.008 0.614~1.653 女性 白细胞计数(× 109/L) 5.101~5.950 ≤ 5.100 0.744 0.291 6.553 0.011 2.105 1.191~3.722 5.951~7.000 1.190 0.285 17.419 < 0.001 3.288 1.880~5.750 > 7.000 1.901 0.273 48.556 < 0.001 6.691 3.920~11.420 中性粒细胞计数(× 109/L) 2.741~3.400 ≤ 2.740 0.893 0.312 8.166 0.004 2.442 1.324~4.504 3.401~4.210 1.047 0.308 11.593 0.001 2.850 1.560~5.207 > 4.210 1.670 0.296 31.767 < 0.001 5.313 2.972~9.496 淋巴细胞计数(× 109/L) 1.711~2.030 ≤ 1.710 0.063 0.266 0.056 0.813 1.069 0.632~1.793 2.031~2.390 0.408 0.248 2.692 0.101 1.503 0.924~2.446 > 2.390 0.789 0.232 11.590 0.001 2.201 1.396~3.466 单核细胞计数(× 109/L) 0.241~0.300 ≤ 0.240 0.250 0.251 0.993 0.319 1.283 0.786~2.097 0.301~0.370 0.139 0.265 0.275 0.560 1.149 0.684~1.930 > 0.370 0.674 0.248 7.417 0.007 1.963 1.208~3.189 嗜酸性粒细胞计数(× 109/L) 0.061~0.090 ≤ 0.060 0.282 0.254 1.232 0.267 1.326 0.806~2.184 0.091~0.140 0.128 0.259 0.242 0.623 1.136 0.683~1.889 > 0.140 0.566 0.247 5.246 0.022 1.761 1.085~2.859 嗜碱性粒细胞计数(× 109/L) 0.010~0.020 ˂ 0.010 – 0.090 0.413 0.048 0.827 0.914 0.406~2.054 0.021~0.030 0.174 0.431 0.164 0.686 1.190 0.512~2.767 > 0.030 0.223 0.420 0.281 0.596 1.249 0.548~2.846 -
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