The Association Between White Blood Cell Count and Insulin Resistance in Community-Dwelling Middle-Aged and Older Populations in Taiwan: A Community-Based Cross-Sectional Study

BACKGROUND: Insulin resistance (IR) is a major pathophysiological factor in the development and progression of diabetes mellitus (DM). DM is highly prevalent in Taiwan and has become one of the most common health problems in family medicine and primary care. We aimed to use white blood cell count (WBC), a common physiological parameter, to develop a simple clinical prediction rule for IR in the middle-aged and old Taiwanese population. METHODS: In this cross-sectional community-based study, the participants completed a questionnaire comprising personal and medical history data and underwent anthropometric measurements and blood sampling. IR was defined as a HOMA-IR index ≥2. Independent t-test, Mann–Whitney U test, chi-square test, Pearson's correlation test, multivariate binary logistic regression, and receiver operating characteristic curves were used to evaluate the association between the WBC count and IR. RESULTS: A total of 398 community-dwelling middle-aged and older persons (34.9% men) with a mean age of 64.43 ± 8.45 years were enrolled for the analysis. A significant association was identified between the WBC counts and IR, with a Pearson's correlation coefficient of 0.37 (p-value <0.001). Multivariate logistic regression revealed that WBC count (OR = 1.50; 95% CI = 1.25–1.81) was an independent risk factor for IR after adjusting for confounding variables. The area under the receiver operating characteristic curve for WBC count was 0.67, and the optimal threshold value was 5.65 1,000/uL. CONCLUSION: A high WBC count is positively related to an increased risk of IR among middle-aged and older people in Taiwan.