Babio, NancyIbarrola-Jurado, NúriaBulló, MònicaMartínez-González, Miguel ÁngelWärnberg, JuliaSalaverría, ItziarOrtega-Calvo, ManuelEstruch, RamónSerra-Majem, LluísCovas, Maria IsabelSorli, José VicenteSalas-Salvadó, Jordi2016-06-292016-06-292013-03-19Babio N, Ibarrola-Jurado N, Bulló M, Martínez-González MÁ, Wärnberg J, Salaverría I, et al. White blood cell counts as risk markers of developing metabolic syndrome and its components in the PREDIMED study. PLoS ONE. 2013; 8(3):e58354http://hdl.handle.net/10668/2239Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; TRIAL REGISTRATION Controlled-Trials.comISRCTN35739639.BACKGROUND The Metabolic Syndrome (MetS) is a cluster of metabolic abnormalities that includes hyperglucemia, hypertension, dyslipidemia and central obesity, conferring an increased risk of cardiovascular disease. The white blood cell (WBC) count has been proposed as a marker for predicting cardiovascular risk. However, few prospective studies have evaluated the relationship between WBC subtypes and risk of MetS. METHODS Participants were recruited from seven PREDIMED study centers. Both a baseline cross-sectional (n = 4,377) and a prospective assessment (n = 1,637) were performed. Participants with MetS at baseline were excluded from the longitudinal analysis. The median follow-up was 3.9 years. Anthropometric measurements, blood pressure, fasting glucose, lipid profile and WBC counts were assessed at baseline and yearly during the follow-up. Participants were categorized by baseline WBC and its subtype count quartiles. Adjusted logistic regression models were fitted to assess the risk of MetS and its components. RESULTS Of the 4,377 participants, 62.6% had MetS at baseline. Compared to the participants in the lowest baseline sex-adjusted quartile of WBC counts, those in the upper quartile showed an increased risk of having MetS (OR, 2.47; 95%CI, 2.03-2.99; P-trend<0.001). This association was also observed for all WBC subtypes, except for basophils. Compared to participants in the lowest quartile, those in the top quartile of leukocyte, neutrophil and lymphocyte count had an increased risk of MetS incidence. Leukocyte and neutrophil count were found to be strongly associated with the MetS components hypertriglyceridemia and low HDL-cholesterol. Likewise, lymphocyte counts were found to be associated with the incidence of the MetS components low HDL-cholesterol and high fasting glucose. An increase in the total WBC during the follow-up was also associated with an increased risk of MetS. CONCLUSIONS Total WBC counts, and some subtypes, were positively associated with MetS as well as hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, all components of MetS.enEnfermedades cardiovascularesEstudios transversalesDieta mediterráneaRecuento de leucocitosRecuento de linfocitosSíndrome X metabólicoMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged::Aged, 80 and overMedical Subject Headings::Diseases::Cardiovascular DiseasesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional StudiesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Diet Therapy::Diet, MediterraneanMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cell Count::Blood Cell Count::Leukocyte CountMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cell Count::Blood Cell Count::Leukocyte Count::Lymphocyte CountMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Metabolic Syndrome XMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Anatomy::Cells::Blood Cells::Leukocytes::Granulocytes::NeutrophilsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective StudiesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk FactorsMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Agedresearch article23526980open access10.1371/journal.pone.00583541932-6203PMC3602299