Abstract
Cross-sectional associations between white blood cell (WBC) count, lymphocyte and granulocyte numbers, and carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV) were examined in a novel older Chinese community sample. A total of 817 men and 760 women from a sub-study of the Guangzhou Biobank Cohort Study had a full blood count measured by an automated hematology analyzer, carotid IMT by B-mode ultrasonography and brachial-ankle PWV by a non-invasive automatic waveform analyzer. Following adjustment for confounders, WBC count (β=0.07, P<0.001) and granulocyte (β=0.07, P<0.001) number were significantly positively related to PWV, but not lymphocyte number. Similarly, WBC count (β=0.08, P=0.03), lymphocyte (β=0.08, P=0.002) and granulocyte (β=0.03, P=0.04) number were significantly positively associated with carotid IMT, but only the association with lymphocyte count survived correction for other cardiovascular risk factors. In conclusion, higher WBC, particularly lymphocyte and granulocyte, count could be used, respectively, as markers of cardiovascular disease risk, measured through indicators of atherosclerosis and arterial stiffness. The associations for WBC count previously observed by others were likely driven by higher granulocytes; an index of systemic inflammation.
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References
Mallika V, Goswami B, Rajappa M . Atherosclerosis pathophysiology and the role of novel risk factors: a clinicobiochemical perspective. Angiology 2007; 58: 513–522.
Thomas GN, Schooling CM, McGhee SM, Ho SY, Cheung BM, Wat NM et al. Metabolic syndrome increases all-cause and vascular mortality: the Hong Kong Cardiovascular Risk Factor Study. Clin Endocrinol 2007; 66: 666–671.
Poredos P . Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 2004; 9: 46–54.
Vlachopoulos C, Aznaouridis K, Stefanadis C . Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55: 1318–1327.
Stehouwer CD, Henry RM, Ferreira I . Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia 2008; 51: 527–539.
Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364.
Zhang MH, Ye P, Luo LM, Xiao WK, Wu HM, Liu DJ . [Associations and related factors between pulse wave velocity and arterial system and augmentation index measured on different sites in a healthy population]. Zhonghua Xin Xue Guan Bing Za Zhi 2010; 38: 998–1005.
Wang Y, Li J, Zhao D, Wei Y, Hou L, Hu D et al. Prevalence and characteristics of atherosclerosis and peripheral arterial disease in a Chinese population of Inner Mongolia. Vasa 2011; 40: 49–56.
Laogun AA, Gosling RG . In vivo arterial compliance in man. Clin Phys Physiol Meas 1982; 3: 201–212.
Bots ML, Dijk JM, Oren A, Grobbee DE . Carotid intima-media thickness, arterial stiffness and risk of cardiovascular disease: current evidence. J Hypertens 2002; 20: 2317–2325.
Albert MA, Ridker PM . Inflammatory biomarkers in African Americans: a potential link to accelerated atherosclerosis. Rev Cardiovasc Med 2004; 5 (Suppl 3): S22–S27.
Nunez J, Nunez E, Sanchis J, Bodi V, Llacer A . Prognostic value of leukocytosis in acute coronary syndromes: the cinderella of the inflammatory markers. Curr Med Chem 2006; 13: 2113–2118.
Huang ZS, Jeng JS, Wang CH, Yip PK, Wu TH, Lee TK . Correlations between peripheral differential leukocyte counts and carotid atherosclerosis in non-smokers. Atherosclerosis 2001; 158: 431–436.
Liu Q, Zhao D, Wang W, Liu J, Sun JY, Qin LP et al. [The association between white blood cell count and 10-year cardiovascular risk in a large Chinese cohort aged 35–64 years]. Zhonghua Xin Xue Guan Bing Za Zhi 2008; 36: 453–457.
Cardellini M, Marini MA, Frontoni S, Hribal ML, Andreozzi F, Perticone F et al. Carotid artery intima-media thickness is associated with insulin-mediated glucose disposal in nondiabetic normotensive offspring of type 2 diabetic patients. Am J Physiol Endocrinol Metab 2007; 292: E347–E352.
Temelkova-Kurktschiev T, Koehler C, Henkel E, Hanefeld M . Leukocyte count and fibrinogen are associated with carotid and femoral intima-media thickness in a risk population for diabetes. Cardiovasc Res 2002; 56: 277–283.
Magyar MT, Szikszai Z, Balla J, Valikovics A, Kappelmayer J, Imre S et al. Early-onset carotid atherosclerosis is associated with increased intima-media thickness and elevated serum levels of inflammatory markers. Stroke 2003; 34: 58–63.
Chambless LE, Folsom AR, Davis V, Sharrett R, Heiss G, Sorlie P et al. Risk factors for progression of common carotid atherosclerosis: the Atherosclerosis Risk in Communities Study, 1987–1998. Am J Epidemiol 2002; 155: 38–47.
Elkind MS, Cheng J, Boden-Albala B, Paik MC, Sacco RL . Elevated white blood cell count and carotid plaque thickness: the northern manhattan stroke study. Stroke 2001; 32: 842–849.
Sekitani Y, Hayashida N, Kadota K, Yamasaki H, Abiru N, Nakazato M et al. White blood cell count and cardiovascular biomarkers of atherosclerosis. Biomarkers 2010; 15: 454–460.
Ames PR, Tommasino C, Fossati G, Matsuura E, Margarita A, Saulino A et al. Lymphocyte subpopulations and intima media thickness in primary antiphospholipd syndrome. Lupus 2005; 14: 809–813.
Lee YJ, Lee JW, Kim JK, Lee JH, Kim JH, Kwon KY et al. Elevated white blood cell count is associated with arterial stiffness. Nutr Metab Cardiovasc Dis 2009; 19: 3–7.
Selzer F, Sutton-Tyrrell K, Fitzgerald SG, Pratt JE, Tracy RP, Kuller LH et al. Comparison of risk factors for vascular disease in the carotid artery and aorta in women with systemic lupus erythematosus. Arthritis Rheum 2004; 50: 151–159.
Wang W, Wu YF, Zhao D, Yang Y, Lang LR, Wang M et al. [Distribution characteristics and risk factors of carotid atherosclerosis in middle-aged and elderly Chinese]. Zhonghua Xin Xue Guan Bing Za Zhi 2010; 38: 553–557.
Takasu J, Budoff MJ, Katz R, Rivera JJ, O’Brien KD, Shavelle DM et al. Relationship between common carotid intima-media thickness and thoracic aortic calcification: the multi-ethnic study of atherosclerosis. Atherosclerosis 2010; 209: 142–146.
Takasu J, Katz R, Nasir K, Carr JJ, Wong N, Detrano R et al. Relationships of thoracic aortic wall calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J 2008; 155: 765–771.
Wong ND, Lopez VA, Allison M, Detrano RC, Blumenthal RS, Folsom AR et al. Abdominal aortic calcium and multi-site atherosclerosis: the multiethnic study of atherosclerosis. Atherosclerosis 2011; 214: 436–441.
Grewal J, Anand S, Islam S, Lonn E . Prevalence and predictors of subclinical atherosclerosis among asymptomatic ‘low risk’ individuals in a multiethnic population. Atherosclerosis 2008; 197: 435–442.
Jiang CQ, Lam TH, Lin JM, Liu B, Yue XJ, Cheng KK et al. An overview of the Guangzhou biobank cohort study-cardiovascular disease subcohort (GBCS-CVD): a platform for multidisciplinary collaboration. J Hum Hypertens 2010; 24: 139–150.
Deng HB, Macfarlane DJ, Thomas GN, Lao XQ, Jiang CQ, Cheng KK et al. Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study. Med Sci Sports Exerc 2008; 40: 303–307.
Taniguchi A, Fukushima M, Kuroe A, Sakaguchi K, Hashimoto H, Yoshioka I et al. Metabolic syndrome, insulin resistance, and atherosclerosis in Japanese type 2 diabetic patients. Metabolism 2007; 56: 1099–1103.
Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J . Intima-media thickness: a new tool for diagnosis and treatment of cardiovascular risk. J Hypertens 2002; 20: 159–169.
Smith JA . Neutrophils, host defense, and inflammation: a double-edged sword. J Leukoc Biol 1994; 56: 672–686.
Sala A, Folco G . Neutrophils, endothelial cells, and cysteinyl leukotrienes: a new approach to neutrophil-dependent inflammation? Biochem Biophys Res Commun 2001; 283: 1003–1006.
Siminiak T, Flores NA, Sheridan DJ . Neutrophil interactions with endothelium and platelets: possible role in the development of cardiovascular injury. Eur Heart J 1995; 16: 160–170.
Libby P, Okamoto Y, Rocha VZ, Folco E . Inflammation in atherosclerosis: transition from theory to practice. Circ J 2010; 74: 213–220.
Schiffrin EL . T lymphocytes: a role in hypertension? Curr Opin Nephrol Hypertens 2010; 19: 181–186.
Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005; 45: 1638–1643.
Tanigawa T, Kitamura A, Yamagishi K, Sakurai S, Nakata A, Yamashita H et al. Relationships of differential leukocyte and lymphocyte subpopulations with carotid atherosclerosis in elderly men. J Clin Immunol 2003; 23: 469–476.
Huang ZS, Chien KL, Yang CY, Wang CH, Chang TC, Chen CJ . Peripheral differential leukocyte counts and subsequent mortality from all diseases, cancers, and cardiovascular diseases in Taiwanese. J Formos Med Assoc 2003; 102: 775–781.
Kawaguchi H, Mori T, Kawano T, Kono S, Sasaki J, Arakawa K . Band neutrophil count and the presence and severity of coronary atherosclerosis. Am Heart J 1996; 132: 9–12.
Sweetnam PM, Thomas HF, Yarnell JW, Baker IA, Elwood PC . Total and differential leukocyte counts as predictors of ischemic heart disease: the Caerphilly and Speedwell studies. Am J Epidemiol 1997; 145: 416–421.
Lin HF, Liu CK, Liao YC, Lin RT, Chen CS, Juo SH . The risk of the metabolic syndrome on carotid thickness and stiffness: sex and age specific effects. Atherosclerosis 2010; 210: 155–159.
Tomiyama H, Yamashina A, Arai T, Hirose K, Koji Y, Chikamori T et al. Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement—a survey of 12517 subjects. Atherosclerosis 2003; 166: 303–309.
Weber C, Zernecke A, Libby P . The multifaceted contributions of leukocyte subsets to atherosclerosis: lessons from mouse models. Natl Rev Immunol 2008; 8: 802–815.
Wykretowicz A, Guzik P, Kasinowski R, Krauze T, Bartkowiak G, Dziarmaga M et al. Augmentation index, pulse pressure amplification and superoxide anion production in patients with coronary artery disease. Int J Cardiol 2005; 99: 289–294.
Acknowledgements
The study is funded by the National Natural Science Foundation of China/Research Grants Council (No. 30518001; HKU720/05) grant. The main cohort study was funded by The University of Hong Kong Foundation for Education and Science, Hong Kong; Guangzhou Public Health Bureau, and Guangzhou Science and Technology Committee, Guangzhou, China; and The University of Birmingham, UK. The Guangzhou Cohort Study-Cardiovascular Disease Subcohort (GBCS-CVD) investigators include Guangzhou No. 12 Hospital: Jie Ming Lin, Bin Liu, Xiao Jun Yue, Chao Qiang Jiang (Co-PI); The University of Hong Kong: Bernard MY Cheung, Tai Hing Lam (Co-PI); The Chinese University of Hong Kong: Brian Tomlinson, Ka Sing Wong; The University of Birmingham: Kar Keung Cheng, Shahrad Taheri, Paramjit Gill, Greg YH Lip, G Neil Thomas (Co-PI).
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Phillips, A., Jiang, C., Thomas, G. et al. White blood cell subsets are associated with carotid intima-media thickness and pulse wave velocity in an older Chinese population: the Guangzhou Biobank Cohort Study. J Hum Hypertens 26, 485–492 (2012). https://doi.org/10.1038/jhh.2011.58
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DOI: https://doi.org/10.1038/jhh.2011.58
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