Table_1_Associations of levels of peripheral blood leukocyte and subtypes with type 2 diabetes: A longitudinal study of Chinese government employees.docx

ObjectivesAvailable evidence suggests that type 2 diabetes (T2D) may be associated with inflammation and that leukocytes are a topical clinical, biological indicator of inflammation. This study investigates the associations between peripheral blood leukocyte and subtypes levels with T2D.MethodsA total of 5,475 individuals were included in the baseline examination from January 2018 to April 2020, with incidence data updated to April 30, 2021, and follow-up to 5,362 individuals. T2D was defined according to the Chinese guidelines for preventing and treating type 2 diabetes. Physiological and biochemical indicators, including leukocyte and subtypes, were obtained from the physical examination results of the tertiary care hospitals relied on at the cohort sites. Covariates such as demographic characteristics and lifestyle were collected by questionnaire. Binary logistic regression and Cox proportional hazard models were used to explore the correlations. Receiver Operating Characteristic (ROC) curves and time-dependent ROC curves were used to estimate the predictive diagnosis of T2D across the subtype of leukocytes.ResultsThe mean follow-up time was 12 months, and the cumulative incidence density of T2D was 4.0/1000 person-years. Cross-sectional results at baseline showed that the levels of peripheral blood leukocyte and its subtypes were higher in the T2D group than in the non-T2D group. Total leukocyte count and subtypes levels were grouped by quintile. After adjusting for age, sex, family history of diabetes, lifestyle score, and triglyceride levels, all were compared with the lowest quintile of each group. Logistic regression model results showed that the corrected OR for those with the highest quintile level of leukocyte was 2.01 (95% CI: 1.02-3.98). The longitudinal analysis showed that the adjusted HR was 8.43 (95%CI: 1.06-66.92) for those with the highest quintile level of leukocytes at baseline after controlling for the effects of the above covariates. For those with the highest quintile level of neutrophils at baseline, the adjusted HR was 5.05 (95%CI: 1.01-25.29). The leukocyte and subtypes had predictive values for T2D.ConclusionPatients with T2D have a higher level of peripheral blood leukocyte and subtypes than those without the disease. Elevated leukocyte and neutrophil counts may link to a higher risk of T2D.

现有证据表明，2型糖尿病（T2D）可能与炎症相关，而白细胞作为炎症的临场临床和生物学指标，备受关注。本研究旨在探究外周血白细胞及其亚型水平与T2D之间的关联。研究方法：自2018年1月至2020年4月，共纳入5,475名个体进行基线检查，至2021年4月30日更新发病率数据，并对5,362名个体进行随访。T2D的诊断依据中国预防和治疗2型糖尿病指南。生理和生化指标，包括白细胞及其亚型，均来源于三级护理医院在队列研究点的体检结果。通过问卷调查收集了人口统计学特征和生活方式等协变量。采用二元逻辑回归和Cox比例风险模型探索相关关联。使用受试者工作特征（ROC）曲线和时间依赖性ROC曲线评估T2D亚型中T2D的预测诊断价值。研究结果：平均随访时间为12个月，T2D的累积发病率密度为4.0/1000人年。基线横断面结果显示，与未患T2D组相比，T2D组的白细胞及其亚型水平较高。将白细胞总数及其亚型水平按五分位数分组。在调整年龄、性别、糖尿病家族史、生活方式评分和甘油三酯水平后，所有这些指标均与各组的最低五分位数进行比较。逻辑回归模型结果显示，白细胞最高五分位数水平的校正OR值为2.01（95% CI: 1.02-3.98）。纵向分析显示，在基线时白细胞最高五分位数水平者，调整后的HR为8.43（95%CI: 1.06-66.92），在控制上述协变量的影响后，中性粒细胞最高五分位数水平的调整HR为5.05（95%CI: 1.01-25.29）。白细胞及其亚型对T2D具有预测价值。结论：与未患病者相比，T2D患者的周围血白细胞及其亚型水平较高。升高的白细胞和中性粒细胞计数可能与T2D的更高风险相关。