{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T01:22:57Z","timestamp":1773883377743,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,1,16]],"date-time":"2014-01-16T00:00:00Z","timestamp":1389830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000064","name":"Banting and Best Diabetes Centre (University of Toronto)","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000064","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs Program","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007476","name":"Canadian Diabetes Associaiton","doi-asserted-by":"crossref","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/100007476","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Higher white blood cell count (<jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>) is associated with incident type 2 diabetes; however, little is known about the potential relationship of <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content> subtypes with metabolic abnormalities underlying diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Six hundred and fifty\u2010six nondiabetic participants in the Prospective Metabolism and Islet Cell Evaluation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Granulocytes (basophils, neutrophils and eosinophils), lymphocytes and monocytes were measured in fasting blood samples. Neutrophil lymphocyte ratio (<jats:styled-content style=\"fixed-case\">NLR<\/jats:styled-content>) is the ratio of neutrophil to lymphocyte. Insulin resistance was measured by insulin sensitivity index (<jats:styled-content style=\"fixed-case\">IS<jats:sub>OGTT<\/jats:sub><\/jats:styled-content>) and homeostasis model assessment of insulin resistance (<jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>). Beta\u2010cell dysfunction was measured by insulinogenic index (<jats:styled-content style=\"fixed-case\">IGI<\/jats:styled-content>) divided by <jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">IGI<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>) and Insulin Secretion Sensitivity Index\u20102 (<jats:styled-content style=\"fixed-case\">ISSI<\/jats:styled-content>\u20102).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content> subtypes were inversely associated with <jats:styled-content style=\"fixed-case\">IS<jats:sub>OGTT<\/jats:sub><\/jats:styled-content> [\u03b2\u00a0=\u00a0\u22120\u00b712 (\u22120\u00b715, \u22120\u00b7083) for granulocytes, \u03b2\u00a0=\u00a0\u22120\u00b723 (\u22120\u00b731, \u22120\u00b715) for lymphocytes, \u03b2\u00a0=\u00a0\u22120\u00b767 (\u22121\u00b700, \u22120\u00b734) for monocytes] and positively associated with <jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> [\u03b2\u00a0=\u00a00\u00b711 (0\u00b7074, 0\u00b715) for granulocytes, \u03b2\u00a0=\u00a00\u00b722 (0\u00b714, 0\u00b730) for lymphocytes, \u03b2\u00a0=\u00a00\u00b764 (0\u00b733, 0\u00b797) for monocytes]. Granulocytes and lymphocytes were inversely associated with <jats:styled-content style=\"fixed-case\">IGI<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> [\u03b2\u00a0=\u00a0\u22120\u00b710 (\u22120\u00b715, \u22120\u00b7047), \u03b2\u00a0=\u00a0\u22120\u00b723 (\u22120\u00b735, \u22120\u00b711), respectively] and <jats:styled-content style=\"fixed-case\">ISSI<\/jats:styled-content>\u20102 [\u03b2\u00a0=\u00a0\u22120\u00b7048 (\u22120\u00b7074, \u22120\u00b7022),\u00a0\u03b2\u00a0=\u00a0\u22120\u00b714 (\u22120\u00b719, \u22120\u00b7089), respectively].\u00a0<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> attenuated the associations of monocytes with <jats:styled-content style=\"fixed-case\">IGI<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ISSI<\/jats:styled-content>\u20102, and those of <jats:styled-content style=\"fixed-case\">NLR<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">IS<jats:sub>OGTT<\/jats:sub><\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">NLR<\/jats:styled-content> was not associated with <jats:styled-content style=\"fixed-case\">IGI<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ISSI<\/jats:styled-content>\u20102.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>All <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content> subtypes were independently associated with insulin resistance, whereas granulocytes and lymphocytes, but not monocytes, were associated with \u03b2\u2010cell dysfunction. <jats:styled-content style=\"fixed-case\">NLR<\/jats:styled-content> was not associated with \u03b2\u2010cell dysfunction, and its association with insulin resistance was confounded by obesity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12390","type":"journal-article","created":{"date-parts":[[2013,12,21]],"date-time":"2013-12-21T00:23:57Z","timestamp":1387585437000},"page":"536-541","source":"Crossref","is-referenced-by-count":44,"title":["White blood cell subtypes, insulin resistance and \u03b2\u2010cell dysfunction in high\u2010risk individuals \u2013 the PROMISE cohort"],"prefix":"10.1111","volume":"81","author":[{"given":"Chee\u2010Tin Christine","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stewart B.","family":"Harris","sequence":"additional","affiliation":[{"name":"Centre for Studies in Family Medicine University of Western Ontario London ON 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