Correlation of White Blood Cell, Neutrophils, and Hemoglobin with Metabolic Syndrome and Its Components

Figures & data

Table 1 Baseline Characteristics of MetS Group and Non-MetS Group

	Total (n=7726)	Non-MetS Group (n=5719)	MetS Group (n=2007)	P-value
Male (%)	4379 (56.7)	2766 (48.4)	1613 (80.4)	<0.001
Age (years)	48.40±10.73	47.41±10.73	51.23±10.21	<0.001
Current smoking (%)	1644 (21.3)	958 (16.8)	686 (34.2)	<0.001
Current drinking (%)	1166 (15.1)	647 (11.8)	492 (24.5)	<0.001
Waist circumference (cm)	84.21±9.75	81.07±8.49	93.17±7.23	<0.001
SBP (mmHg)	122.39±16.93	118.79±15.73	132.65±16.01	<0.001
DBP (mmHg)	73.22±11.62	70.81±10.84	80.07±11.02	<0.001
FPG (mmol/L)	5.05±1.17	4.80±0.71	5.76±1.76	<0.001
HbAlc (%)	5.76±0.77	5.61±0.52	6.20±1.12	<0.001
Fasting insulin (μIU/mL)	6.60(4.80,9.30)	5.90(4.40,8.00)	9.40(6.90,12.70)	<0.001
HOMA-IR	1.43(1.01,2.09)	1.25(0.92,1.72)	2.30(1.64,3.22)	<0.001
TC (mmol/L)	4.84±0.92	4.81±0.88	4.93±1.00	<0.001
TG (mmol/L)	1.30(0.91,1.94)	1.11(0.82,1.49)	2.21(1.74,3.04)	<0.001
LDL-C (mmol/L)	2.73±0.74	2.74±0.72	2.73±0.80	0.564
HDL-C (mmol/L)	1.25±0.34	1.34±0.32	1.01±0.25	<0.001
WBC (×10^9/L)	5.80±1.53	5.60±1.44	6.36±1.62	<0.001
Neutrophils (×10^9/L)	3.31±1.12	3.20±1.10	3.64±1.13	<0.001
Hemoglobin (g/L)	144.70±16.41	141.94±16.30	152.56±13.99	<0.001
Platelet (×10^9/L)	229.39±56.10	229.66±56.38	228.61±55.32	0.470
NLR	1.86±0.82	1.85±0.81	1.89±0.84	<0.05

Abbreviations: MetS, metabolic syndrome; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HbAlc, glycosylated hemoglobin; HOMA-IR, insulin resistance index; TC, total cholesterol; TG, triglycerides; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; WBC, white blood cell; NLR, neutrophil-to-lymphocyte ratio.

Table 2 WBC, Neutrophils, Hemoglobin and the Increasing Numbers of Metabolic Disorders

Score	WBC (×10^9/L)	Neutrophils (×10^9/L)	Hemoglobin (g/L)	Platelet (×10^9/L)	NLR
0 (n=2442)	5.33±1.38	3.04±1.08	136.40±15.88	228.33±53.94	1.82±0.81
1 (n=1792)	5.63±1.39	3.23±1.06	144.12±15.47	229.49±59.19	1.86±0.82
2 (n=1485)	5.99±1.51	3.42±1.13	148.44±14.89	232.04±56.78	1.87±0.80
3 (n=1169)	6.24±1.47	3.57±1.10	151.94±14.24	229.18±54.60	1.87±0.83
4 (n=652)	6.53±1.64	3.75±1.16	153.22±13.60	229.75±56.36	1.92±0.89
5 (n=186)	6.54±2.21	3.73±1.19	154.12±13.66	221.08±55.86	1.94±0.77
F-value	120.564	73.301	275.484	1.666	2.175
P-value	<0.001	<0.001	<0.001	0.021	0.767

Abbreviations: MetS, metabolic syndrome; WBC, white blood cell; NLR, neutrophil-to-lymphocyte ratio.

Table 3 Logistic Regression Analysis Showing the Association Between Hematological Parameters and MetS with Its Components

	WBC OR (95% CI)	Neutrophils OR (95% CI)	Hemoglobin OR (95% CI)	Platelet OR (95% CI)	NLR OR (95% CI)
MetS	1.342 (1.291, 1.394)**	1.355 (1.290, 1.423)**	1.033 (1.028, 1.039)**	1.002 (1.001, 1.003)**	1.036 (0.971, 1.105)
Central obesity	1.252 (1.209, 1.297)**	1.229 (1.175, 1.286)**	1.026 (1.021, 1.031)**	1.003 (1.002, 1.003)**	0.963 (0.906, 1.023)
Hypertension	1.229 (1.186, 1.274)**	1.254 (1.197, 1.314)**	1.024 (1.019, 1.029)**	1.003 (1.002, 1.004)**	1.089 (1.023, 1.158)**
Hyperglycemia	1.165 (1.118, 1.214)**	1.223 (1.159, 1.291)**	1.019 (1.013, 1.026)**	1.001 (1.000, 1.002)	1.117 (1.040, 1.200)**
Hypertriglyceridemia	1.292 (1.246, 1.339)**	1.286 (1.229, 1.346) **	1.029 (1.024, 1.034)**	1.003 (1.002, 1.004)**	0.969 (0.912, 1.030)
Low HDL-C	1.253 (1.208, 1.300)**	1.282 (1.222, 1.345) **	1.015 (1.009, 1.020)**	1.001 (1.000, 1.002)*	1.074 (1.008, 1.144)*

Notes: **P<0.01; *P<0.05.

Abbreviations: MetS, metabolic syndrome; WBC, white blood cell; NLR, neutrophil-to-lymphocyte ratio; HDL-C, high-density lipoprotein cholesterol; OR, odds ratio; CI, confidence interval.

Table 4 Predictive Value of WBC, Neutrophils and Hemoglobin for MetS

	AUC (95% CI)	Optimal Cut-Off Value	Sensitivity (%)	Specificity (%)	Youden’s Index
All subjects
WBC	0.650 (0.637, 0.664)**	5.48×10^9/L	70.5	51.2	0.217
Neutrophils	0.625 (0.611, 0.639)**	3.05×10^9/L	68.6	50.6	0.192
Hemoglobin	0.691 (0.678, 0.704)**	144.5g/L	75.1	55.2	0.303
WBC+ neutrophils + hemoglobin	0.717 (0.704,0.729)**	—	69.0	64.2	0.332
Aged <40
WBC	0.720 (0.690, 0.750)**	6.35×10^9/L	63.1	69.1	0.322
Neutrophils	0.670 (0.638, 0.702)**	3.77×10^9/L	53.2	70.8	0.240
Hemoglobin	0.781 (0.755, 0.807)**	146.5g/L	88.5	58.0	0.465
WBC+ neutrophils + hemoglobin	0.819 (0.795, 0.842)**	—	81.4	68.7	0.501
Aged 40–60
WBC	0.660 (0.643, 0.677)**	5.72×10^9/L	61.7	62.1	0.238
Neutrophils	0.631 (0.614, 0.648)**	3.04×10^9/L	68.1	52.5	0.206
Hemoglobin	0.705 (0.689, 0.720)**	143.5g/L	80.0	53.5	0.335
WBC+ neutrophils + hemoglobin	0.731 (0.716, 0.746)**	—	71.5	64.9	0.364
Aged ≥60
WBC	0.606 (0.571, 0.641)**	5.35×10^9/L	66.4	51.8	0.182
Neutrophils	0.597 (0.561, 0.632)**	2.85×10^9/L	73.6	44.0	0.176
Hemoglobin	0.570 (0.534, 0.607)**	146.5g/L	48.5	63.1	0.116
WBC+ neutrophils + hemoglobin	0.604 (0.568, 0.640)**	—	54.3	62.9	0.172

Note: **P<0.01.

Abbreviations: AUC, area under curve; MetS, metabolic syndrome; WBC, white blood cell.

Figure 1 Receiver operating characteristic (ROC) curve analysis of WBC, neutrophils and hemoglobin for MetS.

Figure 2 Receiver operating characteristic (ROC) curve analysis of WBC, neutrophils and hemoglobin for MetS in subjects aged <40.

Figure 3 Receiver operating characteristic (ROC) curve analysis of WBC, neutrophils and hemoglobin for MetS in subjects aged 40–60.

Figure 4 Receiver operating characteristic (ROC) curve analysis of WBC, neutrophils and hemoglobin for MetS in subjects aged ≥60.