Assessment of leukocyte count as a cardiovascular risk marker in prediabetes
Background and Aim: Prediabetes is reported to be associated with the cardiovascular morbidity and mortality in Indian population. This study was conducted to screen out prediabetes (impaired fasting glycemia and impaired glucose tolerance [IGT]) and to assess white blood cell (WBC) counts as a risk factor for future cardiovascular complications. Methods: A total of 200 nondiabetic apparently healthy subjects were selected for the study. Estimation of plasma glucose (PG) levels by GOD‑POD method and oral glucose tolerance test (GTT) was performed in all the subjects. Based on PG and GTT values, these subjects were divided into four groups, Group I: Normal fasting glucose/normal glucose tolerance (NFG/NGT, n = 70), Group II: Isolated Impaired fasting Glucose (iIFG, n = 34), Group III: Isolated IGT (iIGT, n = 38) and Group IV: Impaired fasting glucose and IGT (IFG/IGT, n = 54). WBC counts were estimated in all the subjects and were compared among the groups. Association of WBC with body mass index, systolic blood pressure (SBP), 2 hour post-challenge glucose levels (2 h PG) and rate pressure product was done using correlation analysis. Results: The iIGT and IFG/IGT group had a significantly higher WBC count compared to subjects with NFG/NGT and iIFG group (P < 0.05). However, the WBC counts between the iIGT and IFG/IGT groups were comparable (P > 0.05). WBC counts were significantly associated with rate pressure product in all prediabetic subjects and with SBP and 2 h PG in subjects with IGT. Bivariate regression analysis showed association of WBC with rate pressure product (RPP) a known cardiovascular risk factor in prediabetics after adjusting other parameters. Conclusion: This suggested that WBC count increase with raised 2 h PG in subjects with iIGT, and could be associated with metabolic syndrome and insulin resistance. Increased WBC counts and RPP in subjects with IGT, increases the cardiac risk burden in these subjects compared to subjects with IFG.