Leukocyte count, erythrocyte sedimentation rate, and diabetes incidence in a national sample of US adults.

Emerging data suggest that inflammation may play a role in the etiology of diabetes mellitus. Because few prospective studies have addressed this issue, the author examined the relation between leukocyte count and erythrocyte sedimentation rate and diabetes incidence using data from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (from 1971-1975 to 1992-1993). Of 8,352 participants included in the analysis, 878 developed incident diabetes during the approximately 20-year follow-up. After adjustment for age, smoking status, systolic blood pressure, cholesterol concentration, use of antihypertensive medication, recreational exercise, non-recreational activity, alcohol use, and body mass index, the hazard ratios from proportional hazards for participants with a leukocyte count of > or = 9.1 x 10(9)/liter compared with participants with a leukocyte count of < or = 5.7 x 10(9)/liter were 1.33 (95% confidence interval (CI): 0.81, 2.19) for men and 1.68 (95% CI: 1.21, 2.34) for women. The adjusted hazard ratios for participants with an erythrocyte sedimentation rate of > or = 26 mm/hour compared with participants with an erythrocyte sedimentation rate of < or = 5 mm/hour were 1.85 (95% CI: 0.97, 3.54) for men and 0.83 (95% CI: 0.47, 1.44) for women. These results provide limited support to the hypothesis that inflammation is an etiologic factor for diabetes.

[1]  P W Macfarlane,et al.  Pravastatin and the Development of Diabetes Mellitus: Evidence for a Protective Treatment Effect in the West of Scotland Coronary Prevention Study , 2001, Circulation.

[2]  M. Lazar,et al.  The hormone resistin links obesity to diabetes , 2001, Nature.

[3]  H. Brenner,et al.  Association between C-reactive protein and features of the metabolic syndrome: a population-based study. , 2000, Diabetes care.

[4]  GS Hotamisligil,et al.  Molecular mechanisms of insulin resistance and the role of the adipocyte , 2000, International Journal of Obesity.

[5]  S. Haffner,et al.  Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). , 2000, Circulation.

[6]  A. Folsom,et al.  Fibrinogen, other putative markers of inflammation, and weight gain in middle-aged adults--the ARIC study. Atherosclerosis Risk in Communities. , 2000, Obesity research.

[7]  M. Visser,et al.  Elevated C-reactive protein levels in overweight and obese adults. , 1999, JAMA.

[8]  E. Ford.  Body mass index, diabetes, and C-reactive protein among U.S. adults. , 1999, Diabetes care.

[9]  Gerardo Heiss,et al.  Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): a cohort study , 1999, The Lancet.

[10]  S. Coppack,et al.  C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? , 1999, Arteriosclerosis, thrombosis, and vascular biology.

[11]  A. Döring,et al.  C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. , 1999, Circulation.

[12]  H. King,et al.  Global Burden of Diabetes, 1995–2025: Prevalence, numerical estimates, and projections , 1998, Diabetes Care.

[13]  R Peto,et al.  Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. , 1998, JAMA.

[14]  N. Ray,et al.  Economic Consequences of Diabetes Mellitus in the U.S. in 1997 , 1998, Diabetes Care.

[15]  J. Feldman,et al.  Plan and operation of the NHANES I Epidemiologic Followup Study, 1992. , 1997, Vital and health statistics. Ser. 1, Programs and collection procedures.

[16]  P. Vallance,et al.  Inflammatory cytokines impair endothelium-dependent dilatation in human veins in vivo. , 1997, Circulation.

[17]  L. Kuller,et al.  Lifetime smoking exposure affects the association of C-reactive protein with cardiovascular disease risk factors and subclinical disease in healthy elderly subjects. , 1997, Arteriosclerosis, thrombosis, and vascular biology.

[18]  S. Coppack,et al.  Endothelial Dysfunction: Cause of the Insulin Resistance Syndrome , 1997, Diabetes.

[19]  N. Bharucha,et al.  Stroke management in a large urban hospital in India. , 1997, Stroke.

[20]  R. Gillum,et al.  Erythrocyte sedimentation rate and stroke incidence in the NHANES I Epidemiologic Follow-up Study. , 1997, Stroke.

[21]  J. Corbett,et al.  Irreversible inhibition of metabolic function and islet destruction after a 36-hour exposure to interleukin-1beta. , 1997, Endocrinology.

[22]  L. Kuller,et al.  Relation of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Multiple Risk Factor Intervention Trial. , 1996, American journal of epidemiology.

[23]  H. Becher,et al.  The association of leukocyte count, fibrinogen and C-reactive protein with vascular risk factors and ischemic vascular diseases. , 1996, Thrombosis research.

[24]  D. Strachan,et al.  C Reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study , 1996, BMJ.

[25]  J. Seidell,et al.  The white blood cell count: its relationship to plasma insulin and other cardiovascular risk factors in healthy male individuals , 1996, Journal of internal medicine.

[26]  T. Byers,et al.  Correlates of leukocyte counts in men. , 1996, Annals of epidemiology.

[27]  K. Fearon,et al.  Insulin and counterregulatory hormones influence acute-phase protein production in human hepatocytes. , 1995, The American journal of physiology.

[28]  R. Unger.  Lipotoxicity in the Pathogenesis of Obesity-Dependent NIDDM: Genetic and Clinical Implications , 1995, Diabetes.

[29]  R. Gillum,et al.  Erythrocyte sedimentation rate and coronary heart disease: the NHANES I Epidemiologic Follow-up Study. , 1995, Journal of clinical epidemiology.

[30]  S. Thompson,et al.  Involvement of the hemostatic system in the insulin resistance syndrome. A study of 1500 patients with angina pectoris. The ECAT Angina Pectoris Study Group. , 1993, Arteriosclerosis and thrombosis : a journal of vascular biology.

[31]  G. Paolisso,et al.  Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin-dependent diabetic patients. , 1993, The American journal of clinical nutrition.

[32]  G. Paolisso,et al.  Evidence for a relationship between free radicals and insulin action in the elderly. , 1993, Metabolism: clinical and experimental.

[33]  D. Cook,et al.  The leukocyte count and risk of lung cancer , 1992, Cancer.

[34]  G. Friedman,et al.  The leukocyte count and cancer mortality. , 1991, American journal of epidemiology.

[35]  G. Friedman,et al.  The leukocyte count: a predictor of hypertension. , 1990, Journal of clinical epidemiology.

[36]  D E McMillan,et al.  Increased levels of acute-phase serum proteins in diabetes. , 1989, Metabolism: clinical and experimental.

[37]  J. Madans,et al.  Validity of mortality analysis based on retrospective smoking information. , 1989, Statistics in medicine.

[38]  J. Mclaughlin,et al.  Reliability of surrogate information on cigarette smoking by type of informant. , 1987, American journal of epidemiology.

[39]  J. Neaton,et al.  Prognostic importance of the white blood cell count for coronary, cancer, and all-cause mortality. , 1985, JAMA.

[40]  O. W. van Assendelft,et al.  Total white blood cell counts for persons ages 1-74 years with differential leukocyte counts for adults ages 25-74 years: United States, 1971-75. , 1982, Vital and health statistics. Series 11, Data from the National Health Survey.

[41]  R. Prentice,et al.  Leukocyte counts and cerebrovascular disease. , 1982, Journal of chronic diseases.

[42]  J. Feldman,et al.  Plan and operation of the HANES I augmentation survey of adults 25-74 years United States, 1974-1975. , 1978, Vital and health statistics. Ser. 1, Programs and collection procedures.

[43]  A. Siegelaub,et al.  The leukocyte count as a predictor of myocardial infarction. , 1974, The New England journal of medicine.

[44]  H. Miller,et al.  Plan and operation of the health and nutrition examination survey. United states--1971-1973. , 1973, Vital and health statistics. Ser. 1, Programs and collection procedures.