title: White blood cell count may identify abnormal cardiometabolic phenotype and preclinical organ damage in overweight/obese children.
abstract: Subclinical inflammation is a central component of cardiometabolic disease risk in obese subjects. The aim of the study was to evaluate whether the white blood cell count (WBCc) may help to identify an abnormal cardiometabolic phenotype in overweight (Ow) or obese (Ob) children.
  
  
  
  A cross-sectional sample of 2835 Ow/Ob children and adolescents (age 6-18 years) was recruited from 10 Italian centers for the care of obesity. Anthropometric and biochemical variables were assessed in the overall sample. Waist to height ratio (WhtR), alanine aminotransferase (ALT), lipids, 2 h post-load plasma glucose (2hPG), left ventricular (LV) geometry and carotid intima-media thickness (cIMT) were assessed in 2128, 2300, 1834, 535 and 315 children, respectively. Insulin resistance and whole body insulin sensitivity index (WBISI) were analyzed using homeostatic model assessment (HOMA-IR) and Matsuda's test. Groups divided in quartiles of WBCc significantly differed for body mass index, WhtR, 2hPG, HOMA-IR, WBISI, lipids, ALT, cIMT, LV mass and relative wall thickness. Children with high WBCc (≥8700 cell/mm(3)) showed a 1.3-2.5 fold increased probability of having high normal 2hPG, high ALT, high cIMT, or LV remodeling/concentric LV hypertrophy, after adjustment for age, gender, pubertal status, BMI and centers.
  
  
  
  This study shows that WBCc is associated with early derangements of glucose metabolism and preclinical signs of liver, vascular and cardiac damage. The WBCc may be an effective and low-cost tool for identifying Ow and Ob children at the greatest risk of potential complications.
authors.affiliation: Department of Internal Medicine, "S. Maria delle Grazie", Pozzuoli Hospital, Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Di Bonito
authors.affiliation: Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pacifico
authors.affiliation: Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere, 100, 00133, Rome, Italy. Electronic address: claudio.chiesa@ift.cnr.it.
authors.forename: C
authors.initials: C
authors.lastname: Chiesa
authors.affiliation: IRCCS Istituto Auxologico Italiano, Department of Medical Sciences & Rehabilitation, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Invitti
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Miraglia Del Giudice
authors.affiliation: Endocrinology and Diabetes, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Baroni
authors.affiliation: Department of Cardiology, "S. Maria delle Grazie", Pozzuoli Hospital, Naples, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Moio
authors.affiliation: Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Pellegrin
authors.affiliation: Pediatric Unit, AOU Udine, Udine, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tomat
authors.affiliation: Department of Pediatrics, AORN Santobono-Pausilipon, Naples, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Licenziati
authors.affiliation: IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Manco
authors.affiliation: Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Maffeis
authors.affiliation: Department of Movement and Wellness Sciences, Parthenope University, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Valerio
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007958:Leukocyte Count; D008107:Liver Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D063766:Pediatric Obesity / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D010641:Phenotype; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D000410:Alanine Transaminase
keywords: Cardiometabolic risk factors; Overweight/obese children; Preclinical signs of organ damage; White blood cell count