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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2019, Vol. 13 Issue (6) : 741-746    https://doi.org/10.1007/s11684-017-0579-7
LETTER TO FRONTIERS OF MEDICINE
White blood cell count and the incidence of hyperuricemia: insights from a community-based study
Jian Liu, Pingyan Shen, Xiaobo Ma, Xialian Yu, Liyan Ni, Xu Hao, Weiming Wang(), Nan Chen
Department of Nephrology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Abstract

Hyperuricemia (HUA) is a risk factor for chronic kidney disease (CKD). The relationship between HUA and white blood cell (WBC) count remains unknown. A sampling survey for CKD was conducted in Sanlin community in 2012 and 2014. CKD was defined as proteinuria in at least the microalbuminuric stage or an estimated GFR of 60 mL/(min·1.73 m2). HUA was defined as serum uric acid>420 µmol/L in men and>360 µmol/L in women. This study included 1024 participants. The prevalence of HUA was 17.77%. Patients with HUA were more likely to have higher levels of WBC count, which was positively associated with HUA prevalence. This association was also observed in participants without CKD, diabetes mellitus, hyperlipidemia, or obesity. Multivariate logistic regression analysis showed that WBC count was independently associated with the risk for HUA in male and female participants. Compared with participants without HUA, inflammatory factors such as high-sensitivity C-reactive protein, tumor necrosis factor-α, and interleukin 6 increased in participants with HUA. Hence, WBC count is positively associated with HUA, and this association is independent of conventional risk factors for CKD.

Keywords white blood cell count      hyperuricemia      chronic kidney disease      inflammation     
Corresponding Authors: Weiming Wang   
Just Accepted Date: 27 December 2017   Online First Date: 25 June 2018    Issue Date: 16 December 2019
 Cite this article:   
Jian Liu,Pingyan Shen,Xiaobo Ma, et al. White blood cell count and the incidence of hyperuricemia: insights from a community-based study[J]. Front. Med., 2019, 13(6): 741-746.
 URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-017-0579-7
http://academic.hep.com.cn/fmd/EN/Y2019/V13/I6/741
Males Females
Non-HUA HUA P value Non-HUA HUA P value
N = 330 N = 74 N = 512 N = 108
Age (year) 55.09±12.73 54.59±16.38 0.81 54.92±13.13 63.50±13.45 <0.01
SBP (mmHg) 130.85±14.37 133.18±12.97 0.20 126.85±15.22 136.23±13.47 <0.01
DBP (mmHg) 85.60±8.18 86.54±9.58 0.387 81.30±8.36 84.86±7.27 <0.01
BMI (kg/m2) 24.54±3.48 26.30±2.97 <0.01 23.49±3.68 26.23±3.78 <0.01
WHR 0.88±0.04 0.91±0.04 <0.01 0.84±0.05 0.86±0.04 <0.01
BUN (µmol/L) 4.96±1.25 5.37±1.31 0.01 4.80±1.26 5.43±1.61 <0.01
UA (µmol/L) 331.71±51.37 469.01±42.06 <0.01 267.90±43.37 402.00±46.86 <0.01
RBC (×1012/L) 4.93±0.42 5.03±0.44 0.08 4.490±0.36 4.50±0.38 0.81
WBC (×109/L) 6.45±1.59 7.09±1.85 <0.01 6.02±1.53 6.64±1.6 <0.01
Hb (g/L) 152.27±12.78 155.81±11.90 0.03 134.71±11.07 135.01±12.97 0.81
eGFR (mL/(min·1.73m2)) 105.36±18.61 97.86±22.28 <0.01 100.78±16.52 88.55±18.16 <0.01
CVD (None:Yes) 301:29 60:14 0.02 449:63 92:16 0.43
Smoking (None:Yes) 117:213 30:44 0.43 507:5 107:1 0.88
Drinking (None:Yes) 170:160 39:35 0.85 504:8 103:5 0.06
Gym (None:Yes) 137:193 34:40 0.82 242:270 50:58 0.45
Hypertension (None:Yes) 225:105 48:26 0.58 405:107 66:42 <0.01
DM (None:Yes) 265:65 63:11 0.34 426:86 80:28 0.03
Hyperlipidemia (None:Yes) 154:176 23:51 0.02 238:274 27:81 <0.01
Tab.1  Characteristics of study cohort by HUA
WBC (×109/L) Total HUA PR% PR c2 P value
Quartile 1 (2.80–4.80) 170 19 11.20 1.00
Quartile 2 (4.81–5.49) 170 23 13.50 1.21
Quartile 3 (5.50–6.07) 170 30 17.60 1.57
Quartile 4 (6.08–6.76) 170 22 12.90 1.15
Quartile 5 (6.77–7.74) 170 42 24.70 2.21
Quartile 6 (7.75–14.1) 171 45 26.32 2.35 21.9 <0.01
Tab.2  Association of WBC levels with prevalence of HUA
Non-HUA HUA P value
N WBC N WBC
Without CKD 758 6.19±1.60 147 6.74±1.56 P<0.01
Without DM 690 6.16±1.58 142 6.67±1.57 P = 0.001
Without hyperlipidemia 391 6.16±1.69 50 6.97±1.91 P = 0.002
BMI<25 kg/m2 527 6.10±1.60 63 6.98±1.77 P<0.01
Without CKD, DM, hyperlipidemia, and BMI≥25 kg/m2 234 6.08±1.71 16 6.98±1.41 P = 0.04
Tab.3  WBC levels in patients without CKD, DM, hyperlipidemia, or obesity
Fig.1  Multivariate-adjusted OR and 95% CI for HUA by quintiles of WBC count in 1021 participates. The analysis was adjusted for age, WBC, SBP, DBP, BMI, WHR, BUN, Hb, RBC, eGFR, medical history (CVD, hypertension, DM, and hyperlipidemia), and health-related behaviors (cigarette smoking, alcohol drinking, and gym). OR estimates were obtained using the lowest quintile of WBC count as the reference. P for trend<0.05.
Males Females
Adjusted OR 95% CI P value AIC Adjusted OR 95% CI P value AIC
Model 1 1.24 1.07–1.43 <0.01 382.19 1.31 1.25–1.49 <0.01 523.34
Model 2 1.26 1.07–1.48 <0.01 356.00 1.28 1.11–1.49 <0.01 460.31
Model 3 1.27 1.08–1.50 <0.01 346.90 1.27 1.10–1.48 <0.01 463.44
Model 4 1.27 1.07–1.50 <0.01 348.23 1.28 1.09–1.50 <0.01 439.61
Tab.4  Comparison of parameters between HUA and normal subjects by multivariate logistic regression model
Fig.2  Serum inflammatory factors in participants with HUA and without HUA.
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