Nutritional status, metabolic changes and white blood cells in adolescents

Oliveira, Thatianne Moreira Silva; Faria, Franciane Rocha de; Faria, Eliane Rodrigues de; Pereira, Patrícia Feliciano; Franceschini, Sylvia C.C.; Priore, Silvia Eloiza

doi:10.1590/S0103-05822014000400011

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Revista Paulista de Pediatria

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Original Articles • Rev. paul. pediatr. 32 (4) • Oct-Dec 2014 • https://doi.org/10.1590/S0103-05822014000400011 copy

Nutritional status, metabolic changes and white blood cells in adolescents^☆ ☆ Study conducted at Universidade Federal de Viçosa, Viçosa, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To analyze the relationship between the peripheral blood white cells, metabolic changes, and nutritional status of adolescents with and without excess weight and body fat.

METHODS:

This cross-sectional study evaluated the body mass index (BMI) and percentage body fat (%BF) in 362 adolescents from 15 to 19 years of age, of both sexes. White blood cell count, platelet count, uric acid, fasting glucose, insulin, and lipid profile were measured. The inclusion criteria were agreement to participate in the study and signature of the informed consent. Exclusion criteria were: presence of chronic or infectious disease; use of medications that could cause changes in biochemical tests; pregnancy; participation in weight reduction and weight control programs; use of diuretics and laxatives; or the presence of a pacemaker. The following statistical tests were applied: Kolmogorov-Smirnov test, Student's t or Mann-Whitney test, Pearson or Spearman correlation tests, and chi-squared test, considering p<0.05.

RESULTS:

Overweight was observed in 20.7% of adolescents. The total cholesterol (TC) had a higher percentage of inadequacy (52.2%), followed by high-density lipoprotein (HDL) (38.4%). There was a positive correlation between white cells and serum lipids, insulin, body fat, and BMI. Monocytes were negatively correlated with BMI, and rods with BMI, body fat, and insulin.

CONCLUSIONS:

Nutritional status is related to an inflammatory process, and adolescents with excess weight or body fat presented higher amounts of white blood cells.

Obesity; Adolescent; Risk factors; Leukocyte count

Parameters	Normal weight Mean±SD or Median (Min-Max)	Excess weight Mean±SD or Median (Min-Max)	p-value
Weight (kg)	57.9 (36.2-88.6)	77.5 (57.5-128.7)	<0.001^a
Waist circumference (cm)	73.5 (59.5-102.5)	89.0 (73.7-128.5)	<0.001^a
Hip circumference (cm)	91.5 (76.0-108.5)	103.5 (89.0-137.2)	<0.001^a
%BF	21.0 (3.9-38.3)	35.1 (11.5-52.5)	<0.001^a
Triglycerides (mg/dL)	60.0 (20.0-209.0)	76.0 (31.0-320.0)	<0.001^a
LDL (mg/dL)	87.0 (39.4-202.8)	91.6 (40.2-153.6)	0.038^a
HDL (mg/dL)	49.9±11.7	44.9±10.5	<0.001^b
VLDL (mg/dL)	12.0 (4.0-41.8)	15.2 (6.2-64.0)	<0.001^a
TC/HDL	3.1±0.7	3.6±0.9	<0.001^b
LDL/HDL	1.8±0.6	2.2±0.7	0.001^b
Insulin (mcU/mL)	7.8 (1.3-20.7)	10.4 (3.9-42.5)	<0.001^a
HOMA-IR	1.6 (0.3-4.4)	2.1 (0.7-9.3)	<0.001^a
Uric acid (mg/dL)	3.6±1.0	3.9±1.2	0.003^b
SBP (mmHg)	103.9±9.4	105.9±9.7	0.102^b
DBP (mmHg)	61.2±7.4	60.6±9.0	0.619^b
Leukocytes (mm³)	6000 (2700-15900)	6100 (2700-10700)	0.56^a
Eosinophils (mm³)	158 (0-1441)	177 (0-600)	0.49^a
Band cells (mm³)	0 (0-636)	0 (0-368)	0.16^a
Segmented (mm³)	3510 (1085-12720)	3654 (1323-8025)	0.46^a
Lymphocytes (mm³)	2000±539	2020±527	0.78^b
Monocytes (mm³)	150 (0-632)	128.0 (0-582)	0.07^a
Platelets (mil/mm³)	247±56	256±56	0.24^b

Parameters	Without excess BF Mean±SD or Median (Min-Max)	With excess BF Mean±SD or Median (Min-Max)	p-value
BMI (kg/m²)	20.5 (17.0-26.3)	22.7 (17.8-45.7)	<0.001^a
Waist circumference (cm)	72.0 (59.5-98.5)	80.5 (63.0-128.5)	<0.001^a
Hip circumference (cm)	89.5 (76.0-106.0)	97.0 (79.5-137.2)	<0.001^a
Triglycerides (mg/dL)	58.0 (20.0-189.0)	66.0 (31.0-320.0)	<0.001^a
LDL (mg/dL)	84.8 (39.4-202.8)	91.4 (40.2-201.4)	<0.001^a
VLDL (mg/dL)	11.6 (4.0-37.8)	13.2 (6.2-64.0)	<0.001^a
TC/HDL	3.1 ± 0.7	3.4 ± 0.8	<0.001^b
LDL/HDL	1.8 ± 0.6	2.0 ± 0.7	0.001^b
Glucose (mg/dL)	84.4 ± 6.4	82.8 ± 6.5	0.021^b
Total Cholesterol (mg/dL)	146.6 ± 26.3	158.7 ± 30.8	<0.001^b
Insulin (mcU/mL)	7.0 (1.3-18.0)	9.5 (2.8-42.5)	<0.001^a
HOMA-IR	1.4 (0.2-4.1)	1.9 (0.6-9.3)	<0.001^a
Uric acid (mg/dL)	3.8 ± 1.0	3.5 ± 1.1	0.004^b
SBP (mmHg)	106.0 ± 9.6	102.5 ± 9.0	<0.001^b
DBP (mmHg)	60.0 ± 7.5	62.0 ± 7.7	0.014^b
Leukocytes (mm³)	5700 (2700-10300)	6300 (3200-15900)	<0.001^a
Eosinophils (mm³)	135 (0-1188)	184 (0-1441)	0.004^a
Band cells (mm³)	0 (0-318)	0 (0-636)	0.029^a
Segmented (mm³)	3240 (1085-7828)	3843(1408-12720)	<0.001^a
Lymphocytes (mm³)	1956 ± 552	2053 ± 516	0.08^b
Monocytes (mm³)	159 (0-434)	134 (0-632)	0.07^a
Platelets (mil/mm³)	2391 ± 55	259 ± 55	0.001^b

Parameters	Female Mean (±SD)/ Median (Min-Max)	Male Mean (±SD)/ Median (Min-Max)	p-value
Weight (kg)	56.4 (36.2-125.3)	65.9 (40.5-128.7)	<0.001^a
Hip circumference (cm)	94.2 (77.5-137.2)	92.0 (76.0-134.2)	0.014^a
%BF	28.4 (13.4-52.5)	14.2 (3.9-43.5)	<0.001^a
LDL (mg/dL)	91.0 (42.2-202.8)	84.8 (39.4-147.0)	0.001^a
HDL (mg/dL)	51.6 ± 11.7	45.8 ± 10.7	<0.001^b
Total Cholesterol (mg/dL)	159.5 ± 30.4	144.4 ± 25.6	<0.001^b
CT/HDL	3.2 ± 0.77	3.29 ± 0.5	0.307^b
LDL/HDL	1.91 ±0.65	1.96 ± 0.69	0.483^b
Glucose (mg/dL)	82.5 ± 6.3	84.8 ± 6.6	0.001^b
Insulin (mcU/mL)	8.9 (2.1-42.5)	7.6 (1.3-21.5)	0.008^a
HOMA-IR	1.7(0.4-9.3)	1.6 (0.3-4.6)	0.044^a
Uric acid (mg/dL)	3.0 ± 0.8	4.3 ± 0.8	<0.001^b
SBP (mmHg)	100.8 ± 8.0	108.3 ± 9.4	<0.001^b
DBP (mmHg)	62.9 ± 6.9	58.7 ± 7.9	<0.001^b
Leukocytes (mm³)	6400 (3300-15900)	5650 (2700-9800)	<0.001^a
Eosinophils (mm³)	156 (0-1441)	166 (0-1188)	0.87^a
Band cells (mm³)	0 (0-636)	0 (0-290)	0.23^a
Segmented (mm³)	3902 (1085-12720)	3188 (1242-6723)	<0.001^a
Lymphocytes (mm³)	2047 ± 499	1955 ± 574	0.1^b
Monocytes (mm³)	150 (0-632)	139 (0-462)	0.35^a
Platelets (mil/mm³)	258 ± 55	239 ± 54	0.001^b

Variables	BMI kg/m²	WC cm	HC cm	%BF	TG mg/dL	LDL mg/dL	HDL mg/dL	TC mg/dL	Glucose mg/dL	Insulin mcU/mL	HOMA-IR	Leuko mm³	Eosi mm³	Mono mm³	Band mm³	Seg mm³	Lympho mm³	Platelets mil/mm³
BMI (kg/m²)	--	0.840^a	0.837^a	0.485^a	0.195^a	0.096	-0.213^a	0.069	0.022	0.317^a	0.303^a	0.096	0.099	-0.166^a	-0.110^b	0.122^a	0.038	0.064
WC (cm)		--	0.822^a	0.523^a	0.278^a	0.153^a	-0.255^a	0.114^b	0.029	0.321^a	0.308^a	0.101	0.118^b	-0.117^b	-0.046	0.113^b	0.051	0.090
HC (cm)			--	0.582^a	0.194^a	0.135^a	-0.146^a	0.093	-0.019	0.350^a	-0.328^a	0.083	0.076	-0.210^a	-0.145^a	0.139^a	-0.015	0.081
%BF				--	0.205^a	0.229^a	0.031	0.284^a	-0.066	0.398^a	0.366^a	0.241^a	0.113^b	-0.094	-0.117^b	0.260^a	0.101	0.190^a
TG (mg/dL)					--	0.295^a	-0.218^a	0.400^a	0.099	0.392^a	0.380^a	0.055	0.068	-0.036	-0.024	-0.032	0.171^a	0.170^a
LDL (mg/dL)						--	0.014	0.911^a	-0.008	0.112^b	0.109^b	0.033	0.040	<0.001	-0.025	-0.015	0.178^a	0.179^a
HDL (mg/dL)							--	0.355^a	-0.038	-0.144^b	-0.118^b	0.106^b	0.019	0.012	0.047	0.102	0.045	0.055
TC (mg/dL)								--	0.003	0.170^a	0.159^a	0.074	-0.029	0.009	0.024	0.013	0.208^a	0.213^a
Glucose (mg/dL)									--	0.216^a	0.359^a	-0.115^b	-0.007	-0.027	-0.004	-0.148^a	0.045	-0.035
Insulin (mcU/mL)										--	0.984^a	0.202^a	0.093	0.089	-0.143^a	0.204^a	0.144^a	0.130^b
HOMA-IR											--	0.175^a	0.081	-0.093	-0.133^b	0.172^a	0.141^a	0.118^b
Leuko (mm³)												--	0.291^a	0.277^a	0.058	0.0887^a	0.485^a	0.307^a
Eosi (mm³)													--	0.067	0.003	0.129^b	0.166^a	0.015
Mono (mm³)														--	0.453^a	0.056	0.336^a	0.120^b
Band (mm³)															--	0.118^b	0.155^a	0.022
Seg (mm³)																--	0.155^a	0.269^a
Lympho (mm³)																	--	0.215^a
Platelets (mil/mm³)																		--

Nutritional status according to BMI
Biochemical Variables	With excess weight % (n=5)	No excess weight % (n=287)	Total % (n=362)	OR	CI (95%)	p
HDL Adequate Inadequate Triglycerides Adequate Inadequate TC/HDL Adequate Inadequate Uric acid < 90 ≥ 90	45.3 54.6 74.6 25.3 80.0 20.0 82.7 17.3	66.2 33.8 87.8 12.2 92.4 7.6 91.0 9.0	61.6 38.1 85.0 14.9 72.7 27.3 89.3 10.7	1 2.43 1 2.44 1 3.01 1 2.1	1.4-4.23 1.24-4.79 1.39-6.49 0.96-4.56	<0.001 0.004 0.001 0.039

Nutritional status according to the percentage of body fat
Biochemical variables	With excess of BF (%) n=181	No excess of BF (%) n=287	Total (%) n=362	OR	CI (95%)	p
Total Cholesterol Adequate Inadequate Triglycerides Adequate Inadequate LDL Adequate Inadequate VLDL Adequate Inadequate Insulin Adequate Inadequate Leukocytes <90 ≥90 Segmented <90 ≥90	42.0 58.0 78.5 21.5 67.4 32.6 85.1 14.9 82.4 17.6 84.6 15.4 86.2 13.8	53.6 46.4 91.7 8.3 78.0 22.0 93.4 6.6 98.4 1.6 94.0 6.0 93.4 6.6	47.8 52.2 85.1 14.9 72.7 27.3 89.3 10.7 67.2 32.8 69.0 31.0 71.7 28.3	1 1.60 1 3.04 1 1.7 1 2.47 1 12.74 1 2.83 1 2.26	1.03-2.47 1.55-6.04 1.04-2.8 1.15-5.37 3.64-53.3 1.3-6.28 1.04-4.95	0.02 <0.001 0.02 0.01 <0.001 0.003 0.02

Nutritional status according to gender
Biochemical variables	Female n=196	Male n=166	Total (%) n=362	OR	CI (95%)	p
Total Cholesterol Adequate Inadequate Band cells <90 ≥90 Segmented <90 ≥90 Platelets <90 ≥90	33.9 66.1 59.5 40.5 16.2 83.8 29.7 70.3	66.1 33.9 40.5 59.4 83.8 16.2 70.3 29.7	47.8 52.2 89.8 10.2 89.8 10.2 89.8 10.2	1 2.81 1 0.54 1 5.01 1 2.16	1.79-4.4 0.26-1.14 1.93-13.77 0.98-4.82	<0.001 0.07 <0.001 0.03

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[1] *Corresponding author.E-mail:tmso282@yahoo.com.br (T.M.S. Oliveira).

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Nutritional status, metabolic changes and white blood cells in adolescents☆ ☆ Study conducted at Universidade Federal de Viçosa, Viçosa, MG, Brazil.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Nutritional status, metabolic changes and white blood cells in adolescents^☆ ☆ Study conducted at Universidade Federal de Viçosa, Viçosa, MG, Brazil.