Correlation between white blood cell count and metabolic syndrome in adolescence

BACKGROUND: Metabolic syndrome (MetS) is associated with increased risk for diabetes and coronary heart disease. Data suggest that MetS starts even in children. Thus, it is important to understand the role of MetS and the risks related to it. Furthermore, white blood cell count (WBCC) is available in routine examination and it has been proved to be related to risks of MetS. METHODS: A total of 1657 subjects aged 14-19 years were enrolled, with normal WBCC (< or =10 x 10(9) cells/L). The subjects were divided into four quartiles according to WBCC (WBCC1-4, from the lowest to highest WBCC) in both genders. RESULTS: The female subjects had significantly lower systolic blood pressure, fasting plasma glucose (FPG), triglyceride (TG), body mass index (BMI) and higher high-density lipoprotein-cholesterol (HDL-C) than the male subjects. When comparing the risks of the quartiles of WBCC, WBCC4 had significant higher BMI than WBCC1 and WBCC2 in both genders; and lower HDL-C than WBCC3 in male subjects. On multiple regression WBCC was positively related with BMI and TG and negatively related to HDL-C in male subjects. In female subjects only BMI was positively correlated with WBCC. Subjects with MetS did not have significant higher WBCC than those without MetS. CONCLUSIONS: In adolescents with normal WBCC, BMI is significantly related to the levels of WBCC and is the earliest component of MetS to be noted in adolescents. Elevated TG and decreased HDL-C could also be important markers for future risk factors only in male subjects.     

White blood cell count,C-reactive protein and erythrocyte sedimentation rate in respiratory syncytial virus infection of the lower respiratory tract

Laboratory findings such as white blood cell (WBC) count, C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) level in patients with bronchiolitis, bronchopneumonia and lobar pneumonia caused by respiratory syncytial virus (RSV) were studied. The diagnosis of having RSV infection of the lower respiratory tract was made on the presence of RSV antigen in nasopharyngeal specimens by means of enzyme immunoassay, on chest X-ray appearances and clinical manifestations. The WBC counts in the lobar pneumonia cases (n = 25, 12 288 ± 6296/mm³) were significantly greater than those for the bronchiolitis (n = 52, 9562 ± 2720/mm³) and bronchopneumonia (n = 43, 8369 ± 3714/mm³) cases. The concentrations of CRP in lobar pneumonia cases (n = 25, 6.5 ± 7.3 mg/dL) were significantly greater than those in the bronchiolitis (n = 52, 1.9 ± 2.0 mg/dL) and bronchopneumonia (n = 43, 2.1 ± 2.4 mg/dL) cases. The ESR levels in the lobar pneumonia cases (n = 24, 43.8 ± 29. mm/h) were also significantly higher than those in the bronchiolitis (n = 34, 20.1 ± 12.3 mm/h) and bronchopneumonia (n = 40, 24.7 ± 15.9 mm/h) cases. There were no significant differences in the WBC counts, the CRP concentrations and ESR levels between the bronchiolitis and bronchopneumonia cases. These results suggest that the RSV lobar pneumonia cases are coinfected with some bacterial organisms more heavily than in the RSV bronchiolitis and bronchopneumonia cases.     

Temperature and total white blood cell count as indicators of bacteremia

This study was designed to quantify more precisely the accuracy of magnitude of rectal temperature and total white blood cell (WBC) count as indicators of bacteremia in children with an obvious focal bacterial infection. A total of 955 children, aged 3 to 36 months, who had rectal temperature greater than or equal to 39.0 degrees C and were seeking care at either of two urban pediatric emergency departments had blood drawn for culture; 885 had blood drawn for WBC count. Twenty-seven had bacteremia. Various combinations of temperature and WBC count were selected to construct receiver-operating-characteristic curves by plotting sensitivity vs false-positive rate (1 - specificity). The receiver-operating-characteristic curve of WBC count provided significantly better diagnostic information than the curve for temperature increments above 39.0 degrees C. Each increment of 0.5 degrees C led to large decrements in sensitivity and false-positive rates. At a WBC count cutoff of 10,000/mm3, the sensitivity was 92% while the false-positive rate was 57%. Using this cutoff point, the clinician could have avoided performing 368 of 955 blood cultures and missed only 2 of 26 children with bacteremia. Receiver-operating-characteristic curves combining WBC count and temperature increments above 39.0 degrees C provided no better diagnostic information than that of WBC count at a temperature cutoff of 39.0 degrees C. It is concluded that increments in temperature above 39.0 degrees C provided additional diagnostic specificity for bacteremia only at the expense of unacceptable decreases in sensitivity. Total WBC count provided better information. A WBC count cutoff of 10,000/mm3 increased specificity with minimal decrease in sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)     

Association between white blood cell count and components of metabolic syndrome

Background:  Components of metabolic syndrome (MetS) were found to be associated with several inflammatory factors including white blood cell count (WBCC), which is an easily available test in clinical practice. In the present study, the relationships between WBCC and MetS components were investigated in children.
Methods:  A total of 288 Taiwanese children, under 10 years old, with normal WBCC, were enrolled in the study. They were divided into quartiles according to WBCC (lowest, WBCC1; highest, WBCC4). The mean values of each MetS component for every group were compared in boys and girls separately. Multivariate linear regression between the WBCC and the MetS components after adjusting for age and body mass index (BMI) were also evaluated.
Results:  In group comparison, only the high-density lipoprotein-cholesterol (HDL-C) was found to be significantly lower in WBCC4 in boys. Other components were not different. After multivariate linear regression, WBCC was negatively correlated to HDL-C and positively to BMI in boys. Although not significant, similar relationships were also observed in girls. Interestingly, borderline positive correlation was noted between triglyceride (TG) and WBCC in girls.
Conclusion:  BMI was positively and HDL-C was negatively related to WBCC in boys. A similar trend could also be observed in girls but without significance. Borderline significant correlation between TG and WBCC was noted in girls. These findings suggest that cardiovascular risks might commence even in childhood. Early detection of children with these abnormalities may help to prevent cardiovascular disease and diabetes in adolescence or even adulthood.     

新生儿末梢血白细胞及其分类的参考区间和影响因素

目的从健康足月新生儿人群中建立末梢血白细胞及其分类的参考区间。方法自2017年11月—2018年4月招募湖北地区2家医院孕母产检正常的592例健康足月新生儿为研究对象,在生后1～4d内采集微量足跟血,2h内完成白细胞及其分类检测。结果初步建立了新生儿末梢血白细胞及其分类的参考区间,以中位数(范围)表示:WBC 20.24(9.97～40.64)×10~9/L;NEU#12.85(4.51～28.76)×10~9/L;LYM#4.63(2.22～8.50)×10~9/L;各指标受性别、分娩方式、生后日龄(1～4d)及胎龄(37～41周)影响情况如下:白细胞各参数在性别间无显著差异(P>0.05);剖宫产出生的新生儿的WBC、NEU#、EOS#均明显低于顺产组(P<0.05);生后日龄对白细胞参数存在组内差异(P<0.001);WBC、NEU#、LYM#、MON#胎龄组内存在显著差异(P<0.05)。结论初步建立了新生儿末梢血白细胞及五分类的参考区间,认为在不同性别间无显著差异,但应基于不同分娩方式、日龄以及胎龄解读检测结果。     

CD20阳性不提示高白细胞计数急性B淋巴细胞白血病患儿预后不良

目的 探讨初诊骨髓白血病细胞CD20表达联合白细胞计数在儿童B系急性淋巴细胞白血病（B-ALL）预后评估中的价值。方法 回顾性分析2008年4月至2015年4月接受CCLG-ALL2008方案治疗的821例初诊B-ALL患儿的临床资料,并随访观察其生存情况。结果 821例患儿中,CD20阴性患儿547例（66.6%）,CD20阳性患儿274例（33.4%）。694例白细胞 < 50×10⁹/L（低白细胞计数）的患儿中,CD20阳性、CD20阴性患儿5年无事件生存（EFS）率分别为65.9%±3.2%、77.3%±2.0%（P=0.001）,5年总生存（OS）率分别为78.3%±2.9%、87.5%±1.6%（P=0.005）;多因素分析示CD阳性是EFS率、OS率的独立危险因素（分别HR=1.634,P=0.001;HR=1.761,P=0.005）。127例白细胞≥50×10⁹/L（高白细胞计数）的患儿中,CD20阳性、CD20阴性患儿5年EFS率分别为64.3%±7.7%、53.7%±5.5%（P=0.135）,5年OS率分别为81.4%±6.4%、58.6%±5.6%（P=0.022）;多因素分析示CD20阳性是OS率的独立保护因素（HR=0.367,P=0.016）。结论 接受CCLG-ALL2008方案治疗的B-ALL患儿中,初诊低白细胞计数、CD20阳性表达者长期预后较差,而初诊高白细胞计数、CD20阳性表达者有较好的生存趋势。     

A comparison of the microerythrocyte sedimentation rate and the macroerythrocyte sedimentation rate methods in pediatric patients

A comparison of the micro- and macroerythrocyte sedimentation rate methods performed in disposable polystyrene tubes using venous blood from 524 pediatric patients demonstrates an excellent correlation between the methods. The micromethod produces values higher than the macromethod at values above 10 mm/h but this difference is not of sufficient magnitude at the clinical decision level to warrant a change in the traditional reference ranges. The mean difference between the two methods in the 10-25 mm/h range is 1.4 mm/h. The high bias of the micromethod is accentuated in samples with hematocrits less than 30%. The micro- and macromethods do not maintain a constant relationship throughout the range evaluated.     

白细胞计数对新生儿早发型败血症的诊断界值探讨

目的 评价白细胞（WBC）计数在新生儿早发型败血症（EOS）诊断中的临床应用价值,探讨WBC诊断的上限界值。方法 回顾性选取2019年1月至2020年3月收治的新生儿EOS患儿306例,以同期580例非感染患儿作为对照组,比较两组患儿一般情况、WBC计数等。根据2003年《新生儿败血症诊疗方案》（简称2003年版诊疗方案）及《新生儿败血症诊断及治疗专家共识（2019年版）》（简称2019年版专家共识）标准分别对WBC计数的诊断价值进行评价。结果 根据两种不同诊疗方案,WBC计数的阳性率均较低（分别为51.3%和32.0%）,但特异度均较高（分别为93.3%和98.6%）。经受试者工作特征曲线分析显示,2003年版诊疗方案WBC计数曲线下面积大于2019年版专家共识（P < 0.05）。结论 WBC计数在诊断EOS中的诊断上限界值以2003年《新生儿败血症诊疗方案》中≥25×10⁹/L更为合理。     

白细胞计数对新生儿早发型败血症的诊断界值探讨

目的 评价白细胞（WBC）计数在新生儿早发型败血症（EOS）诊断中的临床应用价值,探讨WBC诊断的上限界值。方法 回顾性选取2019年1月至2020年3月收治的新生儿EOS患儿306例,以同期580例非感染患儿作为对照组,比较两组患儿一般情况、WBC计数等。根据2003年《新生儿败血症诊疗方案》（简称2003年版诊疗方案）及《新生儿败血症诊断及治疗专家共识（2019年版）》（简称2019年版专家共识）标准分别对WBC计数的诊断价值进行评价。结果 根据两种不同诊疗方案,WBC计数的阳性率均较低（分别为51.3%和32.0%）,但特异度均较高（分别为93.3%和98.6%）。经受试者工作特征曲线分析显示,2003年版诊疗方案WBC计数曲线下面积大于2019年版专家共识（P < 0.05）。结论 WBC计数在诊断EOS中的诊断上限界值以2003年《新生儿败血症诊疗方案》中≥25×10⁹/L更为合理。