Total White Blood Cell Count Mediated the Association Between Increased Arterial Stiffness and Risk of Type 2 Diabetes Mellitus in Chinese Adults

Abstract

Objective: Type 2 diabetes mellitus (T2DM) is known to be related to increased arterial stiffness. However, little is known about the risk of T2DM due to accelerated arterial stiffness and the underlying mechanism involved. We aimed to examine arterial stiffness, as determined by brachial-ankle pulse wave velocity (baPWV), in relation to T2DM among a community-based population and whether the association was mediated by white blood cell (WBC) counts. Approach and results: A total of 1036 Chinese adults aged 64.3 years with complete data were qualified in the present study. The dose-response association between baPWV levels, WBC counts, and risk of T2DM were explored using generalized linear models or multivariate logistic regression models. A mediation analysis was conducted to investigate the role of WBC counts on the association between baPWV and T2DM. After multivariate adjustments, we observed a dose-responsive relationship between increased baPWV and elevated risk of T2DM: comparing extreme tertiles of baPWV, the adjusted odds ratio for T2DM risk was 2.29 (95% CI, 1.32–3.98; P for trend =0.005). In addition, significant dose-dependent relationships were found across baPWV tertiles with increasing total or differential WBC counts, which in turn, were positively related to higher risk of T2DM (all P for trend <0.05). Mediation analyses indicated that total WBC count mediated 4.5% of the association between increased baPWV and elevated T2DM risk. Conclusions: Increased arterial stiffness might increase T2DM risk among middle-aged and older Chinese adults, which was partially mediated by total WBC count.

Arterial Stiffness, Biomarkers of Liver Fat, and the Development of Metabolic Dysfunction in Metabolically Healthy Population: A Prospective Study

“…In the current study, the associations of baPWV with metabolic syndrome and diabetes was more evident in individuals with obesity than in those with normal weight (both P for interaction < 0.001), suggesting that BMI status modified those positive associations. Our findings were consistent with a cross-sectional study ( 13 ) that also indicated that individuals with overweight/obesity, instead of those with normal weight, had significant associations between elevated baPWV levels and diabetes risk. Another study revealed that women had higher susceptibility of arterial stiffening in obesity which predispose to hypertension ( 31 ).…”

“…Muhammad et al ( 12 ) observed that increased arterial stiffness was associated with higher risk of type 2 diabetes. Similar results were also obtained in two Chinese studies, either with cross-sectional design ( 13 ) or among specifically hypertensive patients ( 14 ). In addition, whether baPWV, a direct measurement of arterial stiffness, has any predictive value for the risk of developing metabolic syndrome has not yet been explored.…”

Lower Plasma Albumin, Higher White Blood Cell Count and High-Sensitivity C-Reactive Protein are Associated with Femoral Artery Intima-Media Thickness Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus

“…White blood cell count, a routinely available marker of inflammation, is associated with macro- and microvascular complications 56 and is known to be involved in vascular damage and atherosclerosis, 57 , 58 mediated the association between increased arterial stiffness and risk of type 2 diabetes mellitus. 18 In our study, there was a significant difference in white blood cell count among different IMT groups, and the increase in white blood cell count significantly correlated with IMT and thickened femoral arterial IMT. However, there was no significant difference between men and women.…”

Individual and combined contributions of age-specific and sex-specific pulse pressure and brachial-ankle pulse wave velocity to the risk of new-onset diabetes mellitus

“…In addition, a prospective study of 2429 hypertensive patients showed that baseline baPWV is positively associated with the risk of developing diabetes. 5 More recently, Liu et al 16 found that there is a dose-response relationship between baPWV and the risk of type 2 diabetes, and in a prospective cohort study conducted in China, it was shown that baPWV might be an independent predictor of new-onset type 2 diabetes. 17 Consistent with these previous findings, the present results show that there is a 1.64-fold increase in the risk of developing diabetes in patients with a high baPWV.…”