Dataset Information

Six-year follow-up study on the association between white blood cell count and fasting blood glucose level in Chinese adults: A community-based health examination survey.

ABSTRACT:

Background

Pre-diabetes is considered to be an important reversible stage of type 2 diabetes (T2DM); thus, early identification of pre-diabetes may help in the prevention of T2DM. This study aimed to explore the relationship between white blood cell (WBC) counts and the cumulative risk of impaired fasting glucose (IFG) regulation at 6 years.

Methods

A community-based health examination survey was conducted among individuals who were randomly selected from 1300 residents living in China in 2010 to 2016. The participants were divided into four groups according to WBC baseline level. This study initially conducted a cross-sectional analysis of the population who underwent physical examination to explore the relationship between WBC count and FBG levels. Then, a follow-up study was conducted on the population who underwent IFG normal physical examination to explore the relationship between baseline WBC count and changes in FBG levels and the cumulative risk of 6-year IFG.

Results

During the 6-year cohort follow-up, 17.2% of the participants developed IFG, and the cumulative incidence rates of IFG in the four groups were 14.7%, 16.3%, 15.8%, and 22.2%. By Cox multiple regression equation the hazard ratio (HR) of the IFG increased by 18.7% for each additional unit of baseline WBC count with no adjustment of any factor. After adjusting factors, HR increased by 8.4%.

Conclusion

Increased WBC counts are associated with risk of IFG, suggesting chronic inflammation may be involved in the development and progression of IFG.

SUBMITTER: Zang X

PROVIDER: S-EPMC6519278 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Six-year follow-up study on the association between white blood cell count and fasting blood glucose level in Chinese adults: A community-based health examination survey.

Zang Xiu X Meng Xiangyu X Wang Yun Y Jin Xiao X Wu Tingting T Liu Xuekui X Geng Houfa H Xu Wei W Wang Yu Y Teng Fei F Qiu Qinqin Q Yang Manqing M Liang Jun J

Diabetes/metabolism research and reviews 20190206 4

<h4>Background</h4>Pre-diabetes is considered to be an important reversible stage of type 2 diabetes (T2DM); thus, early identification of pre-diabetes may help in the prevention of T2DM. This study aimed to explore the relationship between white blood cell (WBC) counts and the cumulative risk of impaired fasting glucose (IFG) regulation at 6 years.<h4>Methods</h4>A community-based health examination survey was conducted among individuals who were randomly selected from 1300 residents living in ...[more]

PMID: 30614185

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Project description:ObjectivesTo determine whether direct access to hospital review initiated by patients with rheumatoid arthritis would result in improved clinical and psychological outcome, reduced overall use of healthcare resources, and greater satisfaction with care than seen in patients receiving regular review initiated by a rheumatologist.DesignTwo year randomised controlled trial extended to six years.SettingRheumatology outpatient department in teaching hospital.Participants209 consecutive patients with rheumatoid arthritis for over two years; 68 (65%) in the direct access group and 52 (50%) in the control group completed the study (P = 0.04).Main outcome measuresClinical outcomepain, disease activity, early morning stiffness, inflammatory indices, disability, grip strength, range of movement in joints, and bone erosion. Psychological status: anxiety, depression, helplessness, self efficacy, satisfaction, and confidence in the system. Number of visits to hospital physician and general practitioner for arthritis.ResultsParticipants were well matched at baseline. After six years there was only one significant difference between the two groups for the 14 clinical outcomes measured (deterioration in range of movement in elbow was less in direct access patients). There were no significant differences between groups for median change in psychological status. Satisfaction and confidence in the system were significantly higher in the direct access group at two, four, and six years: confidence 9.8 v 8.4, 9.4 v 8.0, 8.7 v 6.9; satisfaction 9.3 v 8.3, 9.3 v 7.7, 8.9 v 7.1 (all P < 0.02). Patients in the direct access group had 38% fewer hospital appointments (median 8 v 13, P < 0.0001).ConclusionsOver six years, patients with rheumatoid arthritis who initiated their reviews through direct access were clinically and psychologically at least as well as patients having traditional reviews initiated by a physician. They requested fewer appointments, found direct access more acceptable, and had more than a third fewer medical appointments. This radical responsive management could be tested in other chronic diseases.

Project description:BACKGROUND:We previously reported that a median of 5.6 years of intensive as compared with standard glucose lowering in 1791 military veterans with type 2 diabetes resulted in a risk of major cardiovascular events that was significantly lower (by 17%) after a total of 10 years of combined intervention and observational follow-up. We now report the full 15-year follow-up. METHODS:We observationally followed enrolled participants (complete cohort) after the conclusion of the original clinical trial by using central databases to identify cardiovascular events, hospitalizations, and deaths. Participants were asked whether they would be willing to provide additional data by means of surveys and chart reviews (survey cohort). The prespecified primary outcome was a composite of major cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, new or worsening congestive heart failure, amputation for ischemic gangrene, and death from cardiovascular causes. Death from any cause was a prespecified secondary outcome. RESULTS:There were 1655 participants in the complete cohort and 1391 in the survey cohort. During the trial (which originally enrolled 1791 participants), the separation of the glycated hemoglobin curves between the intensive-therapy group (892 participants) and the standard-therapy group (899 participants) averaged 1.5 percentage points, and this difference declined to 0.2 to 0.3 percentage points by 3 years after the trial ended. Over a period of 15 years of follow-up (active treatment plus post-trial observation), the risks of major cardiovascular events or death were not lower in the intensive-therapy group than in the standard-therapy group (hazard ratio for primary outcome, 0.91; 95% confidence interval [CI], 0.78 to 1.06; P?=?0.23; hazard ratio for death, 1.02; 95% CI, 0.88 to 1.18). The risk of major cardiovascular disease outcomes was reduced, however, during an extended interval of separation of the glycated hemoglobin curves (hazard ratio, 0.83; 95% CI, 0.70 to 0.99), but this benefit did not continue after equalization of the glycated hemoglobin levels (hazard ratio, 1.26; 95% CI, 0.90 to 1.75). CONCLUSIONS:Participants with type 2 diabetes who had been randomly assigned to intensive glucose control for 5.6 years had a lower risk of cardiovascular events than those who received standard therapy only during the prolonged period in which the glycated hemoglobin curves were separated. There was no evidence of a legacy effect or a mortality benefit with intensive glucose control. (Funded by the VA Cooperative Studies Program; VADT ClinicalTrials.gov number, NCT00032487.).

Dataset Information

Six-year follow-up study on the association between white blood cell count and fasting blood glucose level in Chinese adults: A community-based health examination survey.

Background

Methods

Results

Conclusion

Publications

Six-year follow-up study on the association between white blood cell count and fasting blood glucose level in Chinese adults: A community-based health examination survey.

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