Complete Blood Count Constituents as an Unbiased Indicators for Healthiness in Obese Men: An 6-years Intervals don t worthy for Obese Control study

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1 Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): 217 Complete Blood Count Constituents s n Unised Indictors for Helthiness in Oese Men: An 6-yers Intervls don t worthy for Oese study Astrct Rowid Essm Kdoom Fris Nji Aoud Al Treq Shkir Dept. of Biology, College of Science, University of Bylon, Hill, Irq. rowidessm91@gmil.com The present study imed to use the complete lood count test (CBC) s mrker for helthiness for oese in ddition to control sujects. The study smples included 6 men s oese groups (These groups were divided into overweight (BMI ), oesity clss I (BMI ) nd oesity clss II (BMI ) nd 6 men s control. Both the sujects nd controls underwent questioning where the sme criteri re used. The present study demonstrted not significnt differences in most lood prmeters in oese groups compred with control groups in different ge groups. The results of present study recommended to use the lood prmeters which did not show significnt differences s indictor for helthiness in oese sujects fter questionnire filter. Keywords: oesity, complete lood count, helthiness, yers intervls. الخالصة ىدفت الد ارسة الحالية الى استخدام فحص عد الدم الكمي كدليل لصحة االشخاص الذين يعانون من السمنة باإلضافة الى عينات السيطرة. تضمنت عينات الد ارسة 6 رجال كمجاميع سمنة )قسمت ىذه المجاميع الى اصحاب الوزن ال ازئد مؤشر كتمة الجسم ليم ومجموعة السمنة الصنف االول مؤشر كتمة الجسم ليم ومجموعة السمنة الصنف الثاني مؤشر كتمة الجسم ليم ) و 6 رجال لمجموعة السيطرة. كل من مجاميع السمنة والسيطرة خضعوا لالستبانة حيث استخدمت نفس المعايير. أظيرت الد ارسة الحالية بأنو ال توجد فروقات معنوية في معظم معايير الدم في مجاميع السمنة مقارنة بمجموعة السيطرة في مختمف الفئات العمرية. نتائج ىذه الد ارسة توصي باستخدام معممات الدم التي لم تظير فروق معنوية كمؤشر لمصحة العامة في مجاميع السمنة بعد االستبيان. الكممات المفتاحية : السمنة, عد الدم الكمي, الصحة العامة, الفارق العمري. Introduction Oesity is the ccumultion of n excess ody ft, the norml levels of the ody ft in dult mles 12-2 % of the ody weight nd 2-3 % in femles,when the levels higher thn 2 % of the ody weight in mles nd more thn 33% of the ody weight in femles cn e considered oese (Pi-Sunyer,2). nd oesity lso cused chronic diseses such s hypertension, coronry hert disese, hyperlipidemi, dietes type-ii, insulin resistnce, stroke, cncers, sleep disorders nd others (Qureshi et l., 26). Oesity considered n incresing pulic helth chllenge which hs reched epidemic. In 28, ody mss index of Mle nd femle re the highest in some Oceni countries which reched to 33 9 kg/m² for men nd 3 kg/m² for women in Nuru, While in Bngldesh Femle BMI is lowest 2 kg/m² nd BMI in Democrtic Repulic of the Congo is 19 9 kg/m² for mle (Finucne et l.,211). The incresing prevlence of oesity my e resulted from two resons: food ws more ville for everyone nd physicl ctivity of people ws reduced with incresing urniztion nd economiclly growth. When energy intke excellence energy consumption, the excess energy ws stored s lipid in the form of

2 Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): 217 triglycerides in the ody, However when the storge energy exceeds the efforts energy for long period of time, risk of oesity incresed (AL-Hmd,1999). According to the evlution of the World Helth Orgniztion (WHO), in 2 the prevlence of oese individuls ll over the world ws estimted t 9.8%, nd with susequent increse. An urgent preventive ction hs een deemed necessry (Ejim et l.,213). Oesity over recent yers incresed which is minly ttriuted to the environment nd lifestyle effects rther thn genetic determinnts (Rthnyke et l.,214). Adipose tissue considered n ctive endocrine tht releses lrge numers of cytokines nd ioctive meditors such s leptin, diponectin, interleukin-6 (IL-6) nd tumour necrosis fctor-α (TNF-α), which effected not only ody weight ut lso insulin resistnce, dietic, lipid levels, cogultion, firinolysis, inflmmtion nd therosclerosis ( Vn Gl,26). Oesity in dietic individuls considered the lrgest epidemic in the world, so tht the fifth leding cn e cused of deths nd killing 2.8 million people every yer, In the present time, the prevlence of oesity rnges from less thn % in rurl Chin, Jpn nd some Africn countries to levels s high s 7% in n dult popultion of urn Smo, while 68% dults of U.S.A re overweight or oese. (Chuhn et l.,212). Body mss index hs direct effect on hert rte t rest,during exercise nd during fsting in helthy suject (Suer et l.,214). The individuls with oesity nd ging show incresed sympthetic nervous system ctivity, while the weight loss hs positive effect on the sympthetic nervous system lnce (De-Jonge et l.,21). The reltionship etween hemtologicl prmeters, insulin resistnce nd oesity ws uncler. The sent of evidence on the influence of oesity on the hemtologicl prmeters nd on the prticiption of the hemtologicl prmeters in oesity relted to insulin resistnce. RBC, hemogloin nd hemtocrit cn e used to indicte insulin resistnce in non-oese persons nd these prmeters showed significnt ssocition with BMI which is dependent on the ft distriution nd oesity is not ssocited with hemtologicl prmeters chnges (Brzzoni et l.,214). Mny epidemiologicl studies showed significnt correlted etween WBC cells count which consider nonspecific inflmmtory mrker which is incresed in the oesity nd dietes type II (Twig et l., 213). This study imed to use the complete lood count test (CBC) s mrker for helthiness for oese in ddition to control sujects. Mterils nd Methods group This study included 6 smples from lood for control groups. An interviewer mnged questionnire ws used to collect the informtion from the individuls for excluded the sujects with inherited diseses, dietes nd other disorders. Weight nd height were otined, the ody mss index(bmi) ws clculted. The individuls with norml ody mss index etween Kg/m 2 were selected s controls. Sujects The present study included 6 smples lood for oese groups. Sujects included three groups were divided ccording to the ody mss index (BMI). Body mss index ws clculted using the formul BMI= weight (kg)/ height 2 (m) 2. These groups were clssified into overweight (BMI ), oesity clss I (BMI ) nd oesity clss II (BMI ). Sujects with history of chronic mediction use, history of

3 WBC count 1^3/µL Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): 217 chronic nd inherited diseses, dietes, use drugs nd other disorders were excluded from this study. Men sujects nd control groups were divided into four ge groups s follow : group (1) 2-26 yers, group (2) yers, group (3) yers nd group (4) 4-4 yers. Blood collection Blood were collected y venipuncture t 8-1 m fter overnight fst. Seprted into 3 ml untreted gel tue for serum nd 2 ml EDTA treted tue for plsm. The serum nd plsm were frozen t -2C in two replicte until thwed for ssy. Ethics nd sujects were told out the importnce, nd other detils of reserch nd explin the im of this study nd the protocol of ethics. Mny of sujects refused to give the serum smples. Complete lood count (CBC) The hemtology nlysis test for ll control nd sujects chieved y using utomticlly hemtology nlyzer (Mythic 18, Orphee, Frnce) which give results for 19 prmeters. Erythrocyte Sedimenttion Rte (ESR) ESR ws determined y using utomted nlyzer(humnsed2,germny) where the lood smple put in the specific tue nd set the instrument to mix the smple for 3 minutes nd the result ws given fter 1 minutes. Sttisticl Anlysis The sttisticl nlysis pckge for socil science (SPSS) were used for our results nd dt were given in men nd stndrd devition were red out nd comprtive sttistics were performed to show significnt differences etween our dt t level p <.. Results Eighteen lood prmeter were mesured for lood smples of oese men control nd groups. The sttisticl nlysis showed no significnt differences (P >.) in WBC count etween the overweight, oesity clss I, oesity clss II nd control groups in ging groups 2-26 yer nd yer, in ge groups yer the WBC count in oesity clss I nd oesity clss II significnt increse ( P <.) compred to control group, while in ge group 4-4 yer, It ws noticed significnt increse (P <.) in overweight compred to other BMI groups nd control s in the figure (1) c 2-26 yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (1): WBC (men ± SD) count in the control, overweight, oesity clss I nd oesity clss II groups in 1^3/µL. *Different letters men significnt differences etween groups

4 MON Count 1^3/µL Lym count 1^3/µL Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): 217 Figure (2) reveled no significnt differences (P >.) in LYM count etween high BMI groups nd control group in ge groups 2-26 yer nd 4-4 yer, while in ge group yer significnt increse ( p <.)in LYM count oesity clss II compred with other groups, lso it ws showed significnt decrese (P <.) in overweight men compred with control nd oesity groups. Also it ws demonstrted significnt increse ( P <.) in oesity clss I nd oesity clss II compred to control nd overweight groups in ge group yer c Oesity ClssI Oesity Clss II yer yer yer 4-4 yer Figure (2) : LYM count (men ± SD) in the control, overweight, oesity clss I nd oesity clss II group in 1^3/µL. MON showed no significnt differences ( P >.) etween control group nd other high BMI groups in ge groups 2-26 yer nd yer, while in the ge group yer significnt increse ( p <.) in oesity clss II compred with control, overweight nd oesity clss I, lso it ws reveled significnt increse (P <.) in oesity clss I compred with control nd other high BMI groups in ge groups 4-4 yer s in the figure (3) c 2-26 yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (3): MON count (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups. Sttisticl nlysis showed no significnt differences etween control group nd high BMI groups (p >.) in GRA count in ge groups 2-26 yer, yer nd yer, while significnt increse (P <.) in overweight group compred with control nd oesity groups in ge group 4-4 yer s in the figure (4). LYM% showed no significnt differences (p >.) etween control group nd high BMI groups in ge groups 2-26 yer, yer nd yer, while in ge group 4-4 yer, LYM% ws showed significnt decrese (P <.) in overweight nd oesity clss I compred with control nd oesity clss II s in the figure (). figure (6) showed no significnt differences ( P>.) in MON% etween control group, overweight, oesity clss I nd oesity clss II in ge groups 2-26 yer, yer nd yer, while in ge group 4-4yer significnt increse (P<.) in oesity clss I compred with control nd other high BMI groups.

5 GRA % MON % LYM % GRA Count 1^3/µL Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (4): GRA count (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups in 1^3/µL. 4 3 Oesity Clss I Oesity Clss II yer yer yer 4-4 yer Figure (): LYM% (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (6): MON% (men ± SD) in the control, overweight, oesity clss I nd oesity clss II group. Figure (7) reveled no significnt differences ( P >.) in GRA% etween control nd oesity groups in ll ge groups yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (7): GRA % (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups.

6 HCT % HGB Concentrtion g/dl RBC Count 1^6/µL Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): 217 Figure (8) demonstrted no significnt differences ( P >.) in RBC count etween control nd oesity groups in ll ge groups yer yer yer 4-4 yer Figure (8): RBC count (men ± SD) in the control, overweight, oesity clss I nd oesity clss II in 1^6/µL. Oesity Clss I Oesity Clss II Oesity Clss I Oesity Clss II yer yer yer 4-4 yer Figure (9): HGB concentrtion (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups in g/dl. Figure (9) showed no significnt differences ( p >.) in HGB concentrtion in ll ge groups etween control nd oesity groups. HCT reveled no significnt differences ( p >.) etween the oese nd control groups in ll ge groups s in the figure (1). MCV demonstrted no significnt differences ( p >.) in ll ge groups etween control nd high BMI groups s in the figure (11). MCH showed no significnt differences ( p >.) etween the oese nd control groups in ll ge groups s in the figure (12) yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (1): HCT (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups in g/dl.

7 MCHC g/dl MCH pg MCV µm^3 Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (11): MCV (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups in µm^ yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (12): MCH (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups in pg. figure (13) reveled no significnt differences (p >.) in MCHC etween control nd oesity groups in ge groups yer nd yer, while significnt increse ( P <.) in overweight compred with control nd oese groups in ge group 2-26 yer, lso it ws demonstrted significnt increse ( P <.) in overweight nd oesity clss I groups compred with control nd oesity clss II in ge groups 4-4 yer Oesity Clss I Oesity Clss II yer yer yer 4-4 yer Figure (13): MCHC (men ± SD) in the control, overweight, oesity clss I nd oesity clss II groups in g/dl. Figure (14) showed no significnt differences ( p >.) in RDW% in ll ge groups etween control nd oesity groups.

8 PLT 1^3/µL RDW -SD µm^3 RDW % Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): Oesity Clss I Oesity Clss II 2-26 yer yer yer 4-4 yer Figure (14): RDW% (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups. Figure (1) demonstrted no significnt differences ( p >.) in RDW-SD etween control nd oesity groups in ll ge groups yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (1): RDW-SD (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups in µm^3. Figure (16) reveled no significnt differences ( p >.) in PLT etween control nd oesity groups in ll ge groups Oesity Clss I Oesity Clss II yer yer yer 4-4 yer Figure (16): PLT count (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups in 1^3/µ Figure (17) showed no significnt differences (p>.) in MPV in ll ge groups etween control nd oesity groups. Also figure (18) showed no significnt differences (p>.) in PCT etween control nd oesity groups in ll ge groups. Figure (19) sowed no significnt differences (P>.) in PDW% in ll ge groups etween control nd high BMI groups. Figure (2) demonstrted no significnt differences (P>.) in ESR in ge groups yer, yer nd 4-4 yer etween control nd oesity groups, while significnt increse (P <.) in ESR in overweight nd oesity clss II compred with control nd oesity clss I in ge group 2-26 yer.

9 ESR PDW % PCT % MPV µm ^3 Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): yer yer yer 4-4 yer Oesity Clss I Oesity Clss II Figure (17): MPV (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups in µm^ yer yer yer 4-4 yer Figure (18): PCT % (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups. Oesity Clss I Oesity Clss II Oesity Clss I Oesity Clss II yer yer yer 4-4 yer Figure (19): PDW % (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups c Oesity Clss I Oesity Clss II 2-26 yer yer yer 4-4yer Figure (2): ESR (men ±SD) in control, overweight, oesity clss I nd oesity clss II groups. Discussion The negtive correltion etween CBC constituent in our investigtion with minor exception (WBC& MCHC) etween oese (ccording BMI) in different ge groups nd control sujects lredy my not reflect ny develop in metolic

10 Journl of Bylon University/Pure nd Applied Sciences/ No.(3)/ Vol.(2): 217 syndrome. In the present study we hve some of opinions out oese persons. Firstly, oese cn e clssified s helthy nd ptients or not? Secondly the five or six intervls in ge group re worthy for oese control study? our investigtion y CBC constituent using s predictor for our opinions. The our nlysis showed no significnt nlysis (GRA%, RBC, HGB, HCT, MCV, MCH, RDW%,RDW-SD, PLT, PCT%, PDW% ) s compre with control. This negtively reltionship my would expected the normlity etween the control nd oese person.thus, we cn clssify some of oese persons s helthy,regrdless those re overweight or oese clss I or II. In previous studies the showed tht CBC highly correlted with oesity nd compliction of metolic syndrome for exmple the WBC differentil count nd RBC indices count cn e considered the dignostic feture of metolic syndrome, WBC nd Pltelets count showed very significnt correlted with insulin resistnce while RBC count showed no significnt found with insulin resistnce (Chen et l., 26). Also, the elevted of WBC cells ws relted with the decline of insulin sensitivity nd positively with diposity nd investigted the development of dietes type II nd insulin resistnce ws ssocited with the role of inflmmtion (Vozrov et l.22). Tenório et l ( 214) showed tht WBC count is considered mrker ssocited with crdiometolic disorders which contriuted in the development of crdiovsculr diseses in oese individuls, where Crdiorespirtory fitness ws considered good protective fctor ginst helth prolems. Koyshi et l. (21) showed the estimtion of the hemtologicl prmeters which ws conducted s prt of the heth exmintion efore the incidence of Ischemic hert disese, the results of this exmintion were not ised of the presence of the disese itself, In Jpn the hemtologicl exmintion ws n oligtory prt of the periodic helth exmintion. the ove-norml levels of hemtologicl prmeters used to indicte individuls with high risk of Ischemic hert disese. In the cross sectionl study mong office nd professionl workers who received yerly helth exmintions Lohsoonthorn et l (27) showed tht WBC count ws incresed in oth mles nd femles While hemogloin, hemtocrit nd pltelet count were incresed only in femles with metolic syndrome Wnnmethee nd Shper (1994 ) showed in men in 24 British towns significnt reltionship etween hemtocrit nd mny lifestyle fetures, lood pressure nd lood lipid. The current study showed significnt nlysis in WBC in oese s compre with control group in ge nd 4-4 this result corresponding with previous study nd ut not gree especilly in 2-26 nd ge group. Elevted WBC count ws ssocited significntly with mny fctors such s smoking, BMI, lipid profile, glycemic sttus, gender, ge nd HA1c ( Jing et l.,214). Wight loss in the long term ws considered good mrker for reducing leukocyte count, inflmmtory cytokines such s interleukin 1ß, IL-6, TNF- α nd oxidtive stress (Che et l.,213;ishizk et l., 27). Our study didn t include cytokines mesurement, virl profile nd oxidtive profile stff. Thus the incresing WBC my e relted with ech one. According our finding we re im to use the CBC constituent for control selection nd cn e used for clssify oese s helthy or ptient. This mke sense 1 yers s good intervls for ge groups.

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