A Positive Association of Overactivated Immunity with Metabolic Syndrome Risk and Mitigation of Its Association by a Plant-Based Diet and Physical Activity in a Large Cohort Study

Abstract

The association between immunity and metabolic syndrome (MetS) has been studied, but its interaction with lifestyles remains unclear. We studied their association and interactions with lifestyles in 40,768 adults aged over 40 years from a large-scale, hospital-based cohort study collected during 2010–2013. White blood cell counts (WBC) and serum C-reactive protein concentrations (CRP) were used as indexes of immune status. The participants were categorized into four groups by the cutoff points of 6.2 × 109/L WBC(L-WBC) and <0.5 mg/dL CRP(L-CRP): L-WBC+L-CRP(n = 25,604), H-WBC+L-CRP(n = 13,880), L-WBC+H-CRP(n = 464), and H-WBC+H-CRP(n = 820). The participants in the H-WBC+L-CRP were younger and had higher numbers of males than the L-WBC+L-CRP. MetS risk was higher by 1.75- and 1.86-fold in the H-WBC+L-CRP and H-WBC+H-CRP, respectively, than the L-WBC+L-CRP. MetS components, including plasma glucose and triglyceride concentrations, and SBP were elevated in H-WBC+L-CRP and H-WBC+H-CRP compared with L-WBC+L-CR+P. The risk of hyperglycemia and high HbA1c was the highest in the H-WBC+H-CRP among all groups. Areas of WBC counts and serum CRP concentrations were 0.637 and 0.672, respectively, in the receiver operating characteristic curve. Daily intake of energy, carbohydrate, protein, and fat was not significantly different in the groups based on WBC counts and CRP. However, a plant-based diet (PBD), physical activity, and non-smoking were related to lowering WBC counts and CRP, but a Western-style diet was linked to elevating CRP. A high PBD intake and smoking status interacted with immunity to influence MetS risk: a low PBD and current smoking were associated with a higher MetS risk in the H-WBC+H-CRP. In conclusion, overactivated immunity determined by CRP and WBC was associated with MetS risk. Behavior modification with PBD and physical activity might be related to immunity regulation.

Development and Validation of an Insulin Resistance Predicting Model Using a Machine-Learning Approach in a Population-Based Cohort in Korea

“…The AUC of the ROC suggested that MetS could not estimate low- and high-insulin resistance using the HOMA-IR cutoff. MetS was defined according to the 2005 revised National Cholesterol Education Program-Adult Treatment Panel III criteria for Asia [ 21 , 22 ]. The results suggested that MetS did not predict the HOMA-IR risk.…”

Healthy plant-based diets improve dyslipidemias, insulin resistance, and inflammation in metabolic syndrome. A narrative review

“…Park et al. [ 62 ] tested the association between participants’ immunity by measuring plasma CRP and white blood cells (WBC) and different dietary patterns, including PBDs ( n = 40, 764). A PBD, physical activity, and non-smoking were related to lower WBC counts and CRP.…”

Intestinal Microbiomics in Physiological and Pathological Conditions

“…MD characterized by low saturated fat, high monounsaturated fat, fiber, high vitamin B, C, E, and moderate ethanol intake showed in a few studies on CD patients' improvements of the quality of life and mild reducing fecal calprotectin an serum CRP [35,[58][59][60][61]. Another diet studied is a plant-based diet that exerts anti-inflammatory effects, composed of whole grains, cereals, fruits, vegetables, and nuts showed good improvements regarding symptoms, lowering serum CRP, overall WBC, but with the price of requiring supplementation of micronutrients [31,62].…”