白细胞纵向变化轨迹与新发2型糖尿病的相关性  

Correlation between longitudinal change trajectory of white blood cell and new-onset type 2 diabetes mellitus:a cohort study

作　　者：王心凤 高飞[2] 孙英[1] 贾绍友 胡锐 陈伟芬[1] 任金岩 王燕[1] Wang Xinfeng;Gao Fei;Sun Ying;Jia Shaoyou;Hu Rui;Chen Weifen;Ren Jinyan;Wang Yan(Health Management Center,the Affiliated Hospital of Qingdao University,Qingdao 266555,China;Department of Hand and Foot Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266555,China;Dean's Office,the Affiliated Hospital of Qingdao University,Qingdao 266555,China)

机构地区：[1]青岛大学附属医院健康管理中心,青岛266555 [2]青岛大学附属医院手足外科,青岛266555 [3]青岛大学附属医院院长办公室,青岛266555

出　　处：《中华健康管理学杂志》2024年第11期855-860,共6页Chinese Journal of Health Management

摘　　要：目的探讨白细胞(WBC)纵向变化轨迹与新发2型糖尿病(T2DM)的相关性。方法本研究为前瞻性队列研究。选取2019年1月至2023年12月连续5年于青岛大学附属医院健康管理中心进行体检且符合研究标准的2 792例受检者作为研究对象。构建组轨迹模型(GBTM), 根据WBC纵向变化轨迹确定三个轨迹组分别为:低稳定组、中稳定组、高稳定组, 并分析各组T2DM的累计发病率, 应用多因素Cox比例风险回归模型分析总人群、男女分层后各轨迹组与T2DM的发病风险的相关性。利用限制性立方样条(RCS)回归模型评估基线WBC与T2DM发病风险的剂量-反应关系。结果低稳定组、中稳定组及高稳定组累计发病率逐渐升高, 分别为2.5%、5.3%、6.9%(χ^(2)=19.024, P<0.001)。Cox比例风险回归模型调整多种混杂因素后, 男性各WBC轨迹组的T2DM发病风险差异无统计学意义;女性WBC轨迹高稳定组、中稳定组T2DM的发病风险是分别是低稳定组的2.852(95%CI:1.067~7.628)、2.588(95%CI:1.133~5.912)倍(均P<0.05)。RCS曲线分析显示女性WBC与T2DM发病风险呈线性关系(P_(非线性)=0.956), 当WBC>5.53×10^(9)/L时, T2DM风险随WBC增加而升高。结论女性健康体检人群较高的WBC轨迹与新发T2DM发病风险呈正相关。Objective To explore the relationship between the longitudinal change trajectory of white blood cell(WBC)and new-onset type 2 diabetes mellitus(T2DM).Methods It was a prospective cohort study.A total of 2792 people who underwent health examinations at the Health Management Center of the Affiliated Hospital of Qingdao University from January 2019 to December 2023 for five consecutive years and met the research standards were selected as the study subjects.Group-based trajectory modeling(GBTM)was established.The target population was divided into three groups based on the longitudinal change trajectory of WBC:low-stable group,medium-stable group and high-stable group.The cumulative incidence of T2DM in the three groups were analyzed.Multivariate Cox proportional risk regression models were used to analyze the correlation between different WBC trajectory groups and the risk of T2DM in total population,males and females.A restricted cubic spline regression(RCS)model was used to analyze the dose-response relationship between baseline WBC and risk of T2DM.Results The cumulative incidence rate of T2DM in low-stable group,medium-stable group and high-stable group increased gradually,which was 2.5%,5.3%and 6.9%,respectively(χ^(2)=19.024,P<0.001).After adjusting for multiple confounding factors in the Cox proportional hazards regression model,no significant difference in the incidence risk of T2DM among the three WBC trajectory groups in males;While the hazard ratios in the high-stable and medium-stable group in women was 2.852(95%Cl:1.067-7.628)and 2.588(95%Cl:1.133-5.912),respectively,when compared with that in the low-stable group(both P<0.05).RCS curve analysis showed a linear relationship between WBC and the risk of T2DM in female(P_(non-linear)=0.956),when the WBC count was>5.53×10^(9)/L,the risk of T2DM increased with the rise of WBC.Conclusion Higher WBC trajectory is positively correlated with the risk of new-onset T2DM in female health examination population.

关 键 词：糖尿病 2型 白细胞 轨迹模型 队列研究 

分 类 号：R587.1[医药卫生—内分泌]