Relationship between high white blood cell count and insulin resistance (HOMA-IR) in Korean children and adolescents: Korean National Health and Nutrition Examination Survey 2008–2010

Background and aims Increasing evidence has indicated that insulin resistance is associated with inflammation. However, few studies have investigated the association between white blood cell (WBC) count and insulin resistance, as measured by a homeostasis model assessment of insulin resistance (HOMA-IR) in a general pediatric population. This study aimed to examine the association between WBC count and insulin resistance as measured by HOMA-IR in a nationally representative sample of children and adolescents. Methods and results In total, 2761 participants (1479 boys and 1282 girls) aged 10–18 years were selected from the 2008–2010 Korean National Health and Nutrition Examination Survey. Insulin resistance was defined as a HOMA-IR value greater than the 90th percentile. The odds ratios and 95% confidence intervals for insulin resistance were determined using multiple logistic regression analysis. The mean values of most cardiometabolic variables tended to increase proportionally with WBC count quartiles. The prevalence of insulin resistance significantly increased in accordance with WBC count quartiles in both boys and girls. Compared to individuals in the lowest WBC count quartile, the odds ratio for insulin resistance for individuals in the highest quartile was 2.84 in boys and 3.20 in girls, after adjusting for age, systolic blood pressure, body mass index, and waist circumference. Conclusion A higher WBC count was positively associated with an increased risk of insulin resistance in Korean children and adolescents. This study suggests that WBC count could facilitate the identification of children and adolescents with insulin resistance.