Background:
Leukocyte parameters are predicted to be affected in patients with metabolic syndrome (MetS). We conducted a systematic review and meta-analysis to study the association between white blood cell parameters (WBC) in people with and without MetS.
Methods:
PubMed, EMBASE, Scopus and Cochrane Library databases were searched according to the study protocol. The standardized mean difference (SMD) and 95% confidence intervals (CI) of leukocyte markers between individuals with and without MetS were pooled using an inverse variance model. Additionally, a subgroup analysis by sex was performed where possible. Methodological quality assessment was conducted using the Newcastle-Ottawa scale (NOS) for observational studies and the Cochrane Risk of Bias tool 2.0 for Randomized Controlled Trials (RCTs).
Results:
Of 6068 articles identified, 63 were eligible for the study. Compared to controls, individuals with MetS showed significantly higher concentrations of total leukocyte count (SMD [95% CI]: 0.60 [0.55β0.65]; Pβ
<β
.00001; I
2β
=β
100%), neutrophil counts (0.32 [0.28β0.37]; Pβ
<β
.00001; I
2β
=β
99%), lymphocyte counts (0.15 [0.07β0.23]; Pβ
=β
.0004; I
2β
=β
100%), basophil counts (0.01 [0.00β0.02]; Pβ
=β
.02; I
2β
=β
98%), monocyte counts (0.05 [0.02β0.09]; Pβ
=β
.003; I
2β
=β
99%), and neutrophil-to-lymphocyte ratio (0.24 [0.15β0.33]; Pβ
<β
.00001; I
2β
=β
98%). There were no significant differences in the eosinophil count (0.02 [β0.01 to 0.05]; Pβ
=β
.19; I
2β
=β
96%) and monocyte-to-lymphocyte ratio (0.06 [β0.05 to 0.17]; Pβ
=β
.27; I
2β
=β
100%) between patients with and without MetS, however, the lymphocyte-to-monocyte ratio (0.52 [β0.81 to β0.23]; Pβ
=β
.0005; I
2β
=β
52%) tended to be significantly lower in patients with MetS.
Conclusion:
Biomarkers such as total leukocyte count, neutrophil count, lymphocyte count, basophil count, monocyte count and neutrophil-to-lymphocyte ratio are associated with higher levels in patients in MetS and thus can potentially be used for early detection of MetS.