The Relationship Between Peripheral Total And Differential White Blood Cells Count And Metabolic Syndrome For Men In Guangxi:a Case-control Study

ObjectiveInflammation has been involved in the development of metabolic syndrome(MS)in an array of studies.However,little study focuses on the role of systemic inflammation in MS in Guangxi,China.Based on a large-scale population of medical examination of male,We explored the relationship between white blood cells count,neutrophil count,lymphocyte count,platelet count,Neutrophil-to-lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)with the risk of MS and its components in male population of Guangxi by case-control epidemiological study.To provide the scientific support for the prevention,control,and treatment of MS.MethodsThe participants of this study came from(Fangchenggang Area Male Health and Examination Survey,FAMHES),a male health cohort study in Fangchenggang,Guangxi,China.From July 2011 to November 2011,in the medical examination center of the first people’s Hospital of Fangchenggang City,we collected the physical examination information of the male population who volunteered to take part in the physical examination.The subjects were investigated by questionnaire,anthropometry and blood biochemical indexes.All the participants in this study were diagnosed by the latest MS diagnostic criteria that suitable for Chinese population,which were issued by the Diabetes Branch of Chinese Medical Association in the China Guide for the Prevention and treatment of Type 2 Diabetes(2017 Edition).All the participants who were diagnosed with MS were taken as the case group,and 3 non-MS male controls were matched for each case according to their age±2 years.Finally,we recruited767 patients as the case group and 2301 for the control group.When comparing the distribution characteristics of factors between the MS group and the control group,the Wilcoxon rank sum test was used for the quantitative variable,and the chi-square test was used for the qualitative data.We explored the correlation between white blood cell count,neutrophil count,lymphocyte count,platelet count,NLR and PLR levels and the component of MS by Spearman correlation analysis,and draw a correlation heat map according to the correlation coefficient.Conditional logistic regression was used to analyze the association between white blood cell count,neutrophil count,lymphocyte count,platelet count,NLR and PLR and the risk of MS.We explored the dose-response relationship between white blood cell count,neutrophil count,lymphocyte count,platelet count,NLR,PLR and the risk of MS by restricted cubic spline(RCS)combined conditional logistic regression analysis.Results1.Compared with the control group,the levels of waist circumference,BMI,systolic blood pressure,diastolic blood pressure,total cholesterol,fasting triglyceride and fasting blood glucose in MS group were higher(P<0.001);the level of high density lipoprotein in MS group was lower(P<0.001);and the level of low density lipoprotein in MS group was lower(P=0.006).There were significant differences in the education level,smoking status and drinking status between the MS group and the control group(P<0.001),but there was no significant difference in marital status,exercise status,family history of hypertension,family history of diabetes and family history of coronary heart disease and stroke between the MS group and the control group.2.The peripheral white blood cell count,neutrophil count,lymphocyte count and platelet count in the MS group were significantly higher than those in the control group(P<0.001).But there was no significant difference in neutrophil percentage,lymphocyte percentage and NLR level between the case group and the control group(P>0.05).The level of PLR in MS group was significantly lower than control group(P<0.001).3.The results of Spearman correlation analysis showed that white blood cell,neutrophil,lymphocyte and platelet count were negatively correlated with high density lipoprotein(P<0.01),and positively correlated with triglyceride and waist circumference(P<0.01).On the contrary,PLR had a strong positive correlation with high density lipoprotein and a strong negative correlation with triglyceride and waist circumference(P<0.01).4.We performed the conditional logistic regression analysis adjusting for BMI,total cholesterol,LDL,education level,smoking status,drinking status.For the white blood cell count,taking the Q1group≤5.9×10~9/L as reference,the risk of MS in Q3 group(6.90-8.10)×10~9/L is 1.91 times higher than Q1 group(OR=1.91,95%CI:1.38-2.63,P<0.001),and Q4 group(>8.10×10~9/L)is 2.22times higher than Q1 group(OR=2.22,95%CI:1.58-3.10,P<0.001).The risk of MS in Q2,Q3 and Q4 groups of neutrophil count is 1.55,1.71,2.06 times higher than group Q1(≤2.9×10~9/L)with statistically significant.With the increasing of white blood cell count and neutrophil count,the risk of MS is increased,and there is a linear trend(P<0.001).the risk of MS in Q4 group(>3.00×10~9/L)of lymphocyte count is 2.09 times higher than the reference Q1 group(≤2.10×10~9/L)(OR=2.09,95%CI:1.53-2.84,P<0.001);As for platelet count,the risk of MS of the Q4 group(>250.0×10~9/L)is 1.65 times higher than the reference group(≤184.0×10~9/L)with OR=1.65,(95%CI:1.21-2.24,P=0.001);It shows a linear trend between lymphocyte count,platelet count and the risk of MS(P<0.001).No correlation was found between the levels of NLR and PLR and the risk of MS.5.The dose-response relationship shows that the risk of MS increased with the elevated of white blood cell count,neutrophil count,lymphoid count and platelet count(P<0.001),and the risk of MS did not change when NLR and PLR was increasing.Conclusions1.The peripheral blood white blood cell count,neutrophil count,lymphocyte count,and platelet count have different degrees of correlation with MS in the male population of Guangxi,suggesting that the elevated white blood cell count,neutrophil count,lymphocyte count,and platelet count may be the risk factors for MS.2.There is no correlation between NLR and PLR levels and the risk of MS.