White blood cell count, its subsets, and their indexes in type 2 diabetes mellitus: A mini-review
Abstract
Due to the increased prevalence of obesity-related complications, especially type 2 diabetes mellitus (DM2), great attention has been paid to the variety of adipokines and cytokines, i.e. biomarkers, which are secreted by the enlarged visceral adipose tissue. Those pro-inflammatory mediators diminish insulin sensitivity via impairing insulin signalling pathways. If these processes persist, insulin resistance and DM2 occur, with a typical finding of low-grade chronic inflammation. The current review focuses on some hematological indices that reflect the inflammation level, such as white blood cell count, its subsets, and derived indexes. Those parameters are easy to measure, cost-effective, and widely available in a primary care setting. A deeper knowledge of the changes in the mentioned hematological parameters in DM2, in addition to glucoregulation biomarkers, may enable physicians to act promptly when patients with this metabolic disorder are concerned.
References
Papaetis GS, Papakyriakou P, Panagiotou TN. Central obesity, type 2 diabetes and insulin: exploring a pathway full of thorns. Arch Med Sci. 2015;11:463-482.
Klisic A, Kavaric N, Stanisic V, Vujcic S, Spasojevic-Kalimanovska V, Ninic A, et al. Endocan and a novel score for dyslipidemia, oxidative stress and inflammation (DOI score) are independently correlated with glycated hemoglobin (HbA1c) in patients with prediabetes and type 2 diabetes. Arch Med Sci. 2020;16:42-50.
Daryabor G, Kabelitz D, Kalantar K. An update on immune dysregulation in obesity-related insulin resistance. Scand J Immunol. 2019;89(4):e12747.
Blaszczak AM, Jalilvand A, Hsueh WA. Adipocytes, Innate Immunity and Obesity: A Mini-Review. Front Immunol. 2021;12:650768.
Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci. 2020;21:6275.
Čolak E, Pap D. The role of oxidative stress in the development of obesity and obesity-related metabolic disorders. J Med Biochem. 2021;40:1–9.
Ohshita K, Yamane K, Hanafusa M, Mori H, Mito K, Okubo M, et al. Elevated white blood cell count in subjects with impaired glucose tolerance. Diabetes Care. 2004;27(2):491-496.
Naredi M, Jhavar D, Krishnan D. Study of relationship between WBC count and diabetic complications. Int J Adv Med. 2017;4(4):1128-1132.
Gkrania-Klotsas E, Ye Z, Cooper AJ, Sharp SJ, Luben R, Biggs ML, et al. Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PLoS One. 2010;5(10):e13405.
Rodríguez-Rodríguez E, López-Sobaler AM, Ortega RM, Delgado-Losada ML, López-Parra AM, Aparicio A. Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population. Nutrients. 2020;12(3):855.
Klisic A, Kavaric N, Bjelakovic B, Soldatovic I, Martinovic M, Kotur-Stevuljevic J. The association between retinol-binding protein 4 and cardiovascular risk score is mediated by waist circumference in overweight/obese adolescent girls. Acta Clin Croat. 2017;56:92-98.
Mendes BB, Oliveira ACR, Alcântara KC. Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects. Einstein (Sao Paulo). 2019;17:eAO4403.
Klisic A, Scepanovic A, Kotur-Stevuljevic J, Ninic A. Novel leukocyte and thrombocyte indexes in patients with prediabetes and type 2 diabetes mellitus. Eur Rev Med Pharmacol Sci. 2022;26.
Anık A, Çelik E, Anık A.The Relation of Complete Blood Count Parameters with Metabolic and Clinical Parameters in Overweight and Obese Children. J Pediatr Res. 2021;8:161-170.
Dağdeviren M, Akkan T, Yapar D, Karakaya S, Dağdeviren T, Ertuğrul D, et al. Can neutrophil/lymphocyte ratio be used as an indicator of inflammation in patients with hyperthyroidism? J Med Biochem. 2020;39:7–12.
Klisic A, Radoman Vujačić I, Vučković Lj, Ninic A. Total leukocyte count, leukocyte subsets and their indexes in relation to cardiovascular risk in adolescent population. Eur Rev Med Pharmacol Sci. 2021;25:3038-3044.
Liu J, Liu X, Li Y, Quan J, Wei S, An S, et al. The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis. Biosci Rep. 2018;38:72.
Lolmède K, Duffaut C, Zakaroff-Girard A, Bouloumié A. Immune cells in adipose tissue: key players in metabolic disorders. Diabetes Metab. 2011;37:283-290.
Hlapčić I, Vukić Dugac A, Popović-Grle S, Markelić I, Rako I, Rogić D, et al. Influence of disease severity, smoking status and therapy regimes on leukocyte subsets and their ratios in stable chronic obstructive pulmonary disease. Arch Med Sci. doi:10.5114/aoms.2020.100720.
Sevencan NO, Ozkan AE. Associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, albuminuria and uric acid and the estimated glomerular filtration rate in hypertensive patients with chronic kidney disease stages 1-3. Arch Med Sci. 2019;15:1232-1239.
Turcato G, Sanchis-Gomar F, Cervellin G, Zorzi E, Sivero V, Salvagno GL, et al. Evaluation of Neutrophil-lymphocyte and Platelet-lymphocyte Ratios as Predictors of 30-day Mortality in Patients Hospitalized for an Episode of Acute Decompensated Heart Failure. J Med Biochem. 2019;38:452‐460.
Rajwa P, Życzkowski M, Paradysz A,Slabon-Turska M, Suliga K, Bujak K, et al. Novel hematological biomarkers predict survival in renal cell carcinoma patients treated with nephrectomy. Arch Med Sci. 2020;16:1062-1071.
Chen W, Chen K, Xu Z, Hu Y, Liu Y, Liu W, et al. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Predict Mortality in Patients with Diabetic Foot Ulcers Undergoing Amputations. Diabetes Metab Syndr Obes. 2021;14:821-829.
