Data Sheet 1_The association between white blood cell counts and metabolic health obesity among US adults.docx

BackgroundThe correlation between white cell count and metabolically healthy obesity (MHO) remains elusive among obese American adults. This study endeavors to elucidate this association.
MethodsThis study enrolled 6,580 obese patients from the National Health and Nutrition Examination Survey (NHANES). Obesity phenotypes were defined by presence/absence of metabolic syndrome components. Weighted multivariate logistic regression analyses were used to assess the association between white cell count and MHO occurrence. Restricted cubic spline analysis characterized dose–response relationships, and stratified analyses explored these relationships across sociodemographic and lifestyle factors.
ResultsIn this study, MHO prevalence is 11.9% among obese adults. The risk of MHO was inversely correlated with WBC [OR (95%): 0.81 (0.76, 0.86), p < 0.001], lymphocytes [OR (95%): 0.56 (0.47, 0.68), p < 0.001], monocytes [OR (95%): 0.41 (0.22, 0.75), p = 0.004], and neutrophils count [OR (95%): 0.82 (0.76, 0.88), p < 0.001]. WBC and neutrophils showed L-shaped associations, while lymphocytes, monocytes, and RBCs had linear patterns. Furthermore, stratified analyses demonstrated blood cell counts consistently predicted MHO risk across subgroups.
ConclusionIn this study, we provide novel insights into the association between blood cell count and the presence of MHO among obese individuals. Blood cell count is an accessible biomarker for dynamically tracking the presence of MHO.

研究背景：在美国成年肥胖人群中，白细胞计数与代谢健康型肥胖（metabolically healthy obesity, MHO）之间的关联仍尚不明确。本研究旨在阐明这一关联。
研究方法：本研究从美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）中纳入6580名肥胖患者。以代谢综合征组分的有无定义肥胖表型。采用加权多因素logistic回归分析评估白细胞计数与MHO发生的关联；通过限制性立方样条分析刻画剂量-反应关系；分层分析则探索不同社会人口学特征与生活方式亚组间的上述关联。
研究结果：本研究中，成年肥胖人群的MHO患病率为11.9%。MHO发生风险与白细胞计数（white blood cell, WBC）、淋巴细胞、单核细胞及中性粒细胞计数呈负相关：WBC的比值比（95%置信区间）为0.81（0.76, 0.86），P<0.001；淋巴细胞为0.56（0.47, 0.68），P<0.001；单核细胞为0.41（0.22, 0.75），P=0.004；中性粒细胞为0.82（0.76, 0.88），P<0.001。WBC与中性粒细胞计数呈L型关联，而淋巴细胞、单核细胞及红细胞计数（red blood cell, RBC）则呈线性关联。此外，分层分析显示，在各亚组中，血细胞计数均能持续预测MHO发生风险。
研究结论：本研究为肥胖人群血细胞计数与MHO患病状态之间的关联提供了全新见解。血细胞计数是一种可便捷获取的生物标志物，可用于动态监测MHO的患病状态。