Xiang Fang1, Brenda Dorcely2, Xi-Ping Ding3, Shi Yin3, Ni-Huiping Son2, Shi-Lian Hu1, Ira J Goldberg4. 1. Department of Geriatrics, Affiliated Provincial Hospital of Anhui Medical University, No. 17, Lujiang Road, Hefei City 230001, Anhui Province, China; Gerontology Institute of Anhui Province, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, Anhui, China. 2. Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016, United States of America. 3. Department of Geriatrics, Affiliated Provincial Hospital of Anhui Medical University, No. 17, Lujiang Road, Hefei City 230001, Anhui Province, China. 4. Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016, United States of America. Electronic address: Ira.Goldberg@nyumc.org.
Abstract
OBJECTIVE: Systemic inflammation contributes to cardiovascular disease in patients with type 2 diabetes, and elevated white blood cell (WBC) counts are an established risk factor. Our goal is to describe changes in WBCs and inflammatory markers after glycemic reductions in diabetes. RESEARCH DESIGN AND METHODS: This study enrolled 63 subjects with poorly controlled diabetes, defined as hemoglobin A1c (HbA1c) ≥8% [64 mmol/mol]. Circulating granulocytes and mononuclear cells were separated by histopaque double-density protocol. Inflammatory markers from these isolated WBCs were assessed at baseline and after 3 months of medical management. RESULTS: After 3 months, significant glycemic reduction, defined as a decrease in HbA1c ≥ 1.5%, occurred in 42 subjects. Fasting plasma glucose decreased by 47% (165.6 mg/dL), and HbA1c decreased from 10.2 ± 1.8 to 6.8 ± 0.9. Glycemic reductions were associated with a 9.4% decrease in total WBC counts, 10.96% decrease in neutrophils, and 21.74% decrease in monocytes. The mRNA levels of inflammatory markers from granulocytes and mononuclear cells decreased, including receptor for advanced glycation endproducts; S100 calcium binding proteins A8, A9, A12; krüppel-like factor 5; and IL-1. Also, circulating levels of IL-1β and C-reactive protein decreased. Insulin dose was a mediator between HbA1c and both total WBC and neutrophil counts, but not changes in WBC inflammatory markers. In contrast, the 17 subjects without significant glycemic reductions showed no significant differences in their WBC counts and proteins of inflammatory genes. CONCLUSION: Significant glycemic reduction in subjects with poorly controlled diabetes led to reduced circulating WBC counts and inflammatory gene expression.
OBJECTIVE: Systemic inflammation contributes to cardiovascular disease in patients with type 2 diabetes, and elevated white blood cell (WBC) counts are an established risk factor. Our goal is to describe changes in WBCs and inflammatory markers after glycemic reductions in diabetes. RESEARCH DESIGN AND METHODS: This study enrolled 63 subjects with poorly controlled diabetes, defined as hemoglobin A1c (HbA1c) ≥8% [64 mmol/mol]. Circulating granulocytes and mononuclear cells were separated by histopaque double-density protocol. Inflammatory markers from these isolated WBCs were assessed at baseline and after 3 months of medical management. RESULTS: After 3 months, significant glycemic reduction, defined as a decrease in HbA1c ≥ 1.5%, occurred in 42 subjects. Fasting plasma glucose decreased by 47% (165.6 mg/dL), and HbA1c decreased from 10.2 ± 1.8 to 6.8 ± 0.9. Glycemic reductions were associated with a 9.4% decrease in total WBC counts, 10.96% decrease in neutrophils, and 21.74% decrease in monocytes. The mRNA levels of inflammatory markers from granulocytes and mononuclear cells decreased, including receptor for advanced glycation endproducts; S100 calcium binding proteins A8, A9, A12; krüppel-like factor 5; and IL-1. Also, circulating levels of IL-1β and C-reactive protein decreased. Insulin dose was a mediator between HbA1c and both total WBC and neutrophil counts, but not changes in WBC inflammatory markers. In contrast, the 17 subjects without significant glycemic reductions showed no significant differences in their WBC counts and proteins of inflammatory genes. CONCLUSION: Significant glycemic reduction in subjects with poorly controlled diabetes led to reduced circulating WBC counts and inflammatory gene expression.
Authors: Kyoungmin Park; Qian Li; Net Daş Evcimen; Christian Rask-Madsen; Yasutaka Maeda; Ernesto Maddaloni; Hisashi Yokomizo; Takanori Shinjo; Ronald St-Louis; Jialin Fu; Daniel Gordin; Mogher Khamaisi; David Pober; Hillary Keenan; George L King Journal: Arterioscler Thromb Vasc Biol Date: 2017-11-21 Impact factor: 8.311
Authors: Barbora Vozarova; Christian Weyer; Robert S Lindsay; Richard E Pratley; Clifton Bogardus; P Antonio Tataranni Journal: Diabetes Date: 2002-02 Impact factor: 9.461
Authors: Sridevi Devaraj; Anthony T Cheung; Ishwarlal Jialal; Steven C Griffen; Danh Nguyen; Nicole Glaser; Thomas Aoki Journal: Diabetes Date: 2007-08-08 Impact factor: 9.461
Authors: Prabhakara R Nagareddy; Andrew J Murphy; Roslynn A Stirzaker; Yunying Hu; Shiquing Yu; Rachel G Miller; Bhama Ramkhelawon; Emilie Distel; Marit Westerterp; Li-Shin Huang; Ann Marie Schmidt; Trevor J Orchard; Edward A Fisher; Alan R Tall; Ira J Goldberg Journal: Cell Metab Date: 2013-05-07 Impact factor: 27.287
Authors: Peter C Tong; Ka-Fai Lee; Wing-Yee So; Margaret H Ng; Wing-Bun Chan; Matthew K Lo; Norman N Chan; Juliana C Chan Journal: Diabetes Care Date: 2004-01 Impact factor: 19.112
Authors: Philipp Ehlermann; Kai Eggers; Angelika Bierhaus; Patrick Most; Dieter Weichenhan; Johannes Greten; Peter P Nawroth; Hugo A Katus; Andrew Remppis Journal: Cardiovasc Diabetol Date: 2006-03-30 Impact factor: 9.951