ArticleDiabetologia2014
Differential white cell count and incident type 2 diabetes: the Insulin Resistance Atherosclerosis Study.
Article in Diabetologia, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Key biomarkers in type 2 diabetes patients: A systematic review.Diabetes, obesity & metabolism · 2025Pooled it
- Trial
- Whole-exome sequencing-centered genetic evaluation for early-onset obesity in Chinese children: a retrospective single-center cohort.Translational pediatrics · 2026Article
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- Association Between Genotype and Plasma Levels of EPCR in Type 2 Diabetes Mellitus in Jazan Region, Saudi Arabia: A Case-Control Study.International journal of general medicine · 2026Article
- Association between skeletal muscle mass to visceral fat area ratio and insulin resistance in type 2 diabetes.Journal of diabetes and metabolic disorders · 2025Article
- Observational
- The prognostic value of the systemic immunity-inflammation index for cardiovascular and all-cause mortality in cardiovascular disease patients with diabetes or prediabetes.Journal of diabetes investigation · 2025Article
- Identification and Validation of the Key Genes of Diabetic Vasculopathy: Evidence Based on Bioinformatics Analysis and Animal Study.International journal of genomics · 2025Article
- Systemic Inflammatory Indices and Liver Dysfunction in Turner Syndrome Patients: A Retrospective Case-control Study.Journal of the Endocrine Society · 2024Article
- The role of peripheral white blood cell counts in the association between central adiposity and glycemic status.Nutrition & diabetes · 2024Article
- Low-Density Neutrophils Contribute to Subclinical Inflammation in Patients with Type 2 Diabetes.International journal of molecular sciences · 2024Article
- Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights.International journal of molecular sciences · 2024Review
- Article
- Association between Metabolic Syndrome and Leukocytes: Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Investigating the relationship between haematological parameters and metabolic syndrome: A population-based study.Endocrinology, diabetes & metabolism · 2023Article
- Leukocyte subtypes, gelatinases, and their tissue inhibitors in a group of subjects with asymptomatic carotid atherosclerosis.Clinical hemorheology and microcirculation · 2022Article
- An Objective Diagnosis Model with Integrated Metabolic and Immunity Parameters for Phlegm-Dampness Constitution.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Article
- Association Between the Neutrophil-To-Lymphocyte Ratio and Diabetes Secondary to Exocrine Pancreatic Disorders.Frontiers in endocrinology · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
aims/hypothesisWhite cell count has been shown to predict incident type 2 diabetes, but differential white cell count has received scant attention. We examined the risk of developing diabetes associated with differential white cell count and neutrophil:lymphocyte ratio and the effect of insulin sensitivity and subclinical inflammation on white cell associations.
methodsIncident diabetes was ascertained in 866 participants aged 40-69 years in the Insulin Resistance Atherosclerosis Study after a 5 year follow-up period. The insulin sensitivity index (SI) was measured by the frequently sampled IVGTT.
resultsC-reactive protein was directly and independently associated with neutrophil (p < 0.001) and monocyte counts (p < 0.01) and neutrophil:lymphocyte ratio (p < 0.001), whereas SI was inversely and independently related to lymphocyte count (p < 0.05). There were 138 (15.9%) incident cases of diabetes. Demographically adjusted ORs for incident diabetes, comparing the top and bottom tertiles of white cell (1.80 [95% CI 1.10, 2.92]), neutrophil (1.67 [1.04, 2.71]) and lymphocyte counts (2.30 [1.41, 3.76]), were statistically significant. No association was demonstrated for monocyte count (1.18 [0.73, 1.90]) or neutrophil:lymphocyte ratio (0.89 [0.55, 1.45]). White cell and neutrophil associations were no longer significant after further adjusting for family history of diabetes, fasting glucose and smoking, but the OR comparing the top and bottom tertiles of lymphocyte count remained significant (1.96 [1.13, 3.37]). This last relationship was better explained by SI rather than C-reactive protein. CONCLUSIONS/
interpretationA lymphocyte association with incident diabetes, which was the strongest association among the major white cell types, was partially explained by insulin sensitivity rather than subclinical inflammation.
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