DEMONSTRATION OF A RELATIONSHIP BETWEEN WHITE BLOOD-CELL COUNT, INSULIN RESISTANCE, AND SEVERAL RISK-FACTORS FOR CORONARY HEART-DISEASE IN WOMEN

In order to evaluate the relationship between peripheral white blood cell (WBC) count, insulin-mediated glucose uptake, and several risk factors for coronary heart disease (CHD), WBC, plasma glucose and insulin responses to a 75-g oral glucose challenge, fasting plasma cholesterol, high-density-lipoprotein (HDL)-cholesterol, and triglyceride concentration, and systolic and diastolic blood pressure were determined in 63 consecutive female volunteers with normal glucose tolerance. The results demonstrated the presence of statistically significant correlation coefficients between WBC count and both insulin-mediated glucose disposal (r = 0.50, P < 0.001) and insulin response to oral glucose (r = 0. 50, P < 0. 001). Furthermore, WBC count correlated with plasma glucose response to oral glucose (r = 0.48, P < 0.001), fasting plasma triglyceride (r = 0.37, P < 0.005) and HDL-cholesterol concentrations (r = -0.38, P < 0.005), and systolic (r = 0.22, P < 0.1) and diastolic (r = 0.27, P < 0.05) blood pressure. However, the only two variables significantly correlated with WBC count in multivariate regression analysis were insulin resistance (r = 0.49, P < 0.01) and insulin response (r = 0.35, P < 0.05). These data indicate that WBC count is significantly correlated with changes in carbohydrate and lipoprotein metabolism and blood pressure that increase the risk of CHD. However, it appears that these relationships are secondary to resistance to insulin-mediated glucose uptake and hyperinsulinaemia.