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Leukocyte count correlates in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study
F J Nieto1, M Szklo, A R Folsom
1Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
Insights
Elevated leukocyte counts are linked to smoking, male sex, and race, but these associations diminish with adjustments. In non-smokers, higher leukocyte counts correlate with poor health and obesity, suggesting complex links to cardiovascular disease.
Area of Science:
- Cardiovascular epidemiology
- Hematology
- Public health research
Background:
- Leukocyte count is a marker of inflammation and immune response.
- Previous studies suggest associations between leukocyte count and cardiovascular disease risk factors.
- Understanding these associations is crucial for identifying individuals at risk.
Purpose of the Study:
- To investigate cross-sectional associations between leukocyte count and sociodemographic factors.
- To examine the relationship between leukocyte count and various cardiovascular risk factors.
- To explore potential confounding factors in the leukocyte count-cardiovascular disease relationship.
Main Methods:
- Analysis of data from 14,679 participants aged 45-64 years in the Atherosclerosis Risk in Communities Study.
- Cross-sectional investigation of associations between leukocyte count and demographic, lifestyle, and clinical variables.
- Multivariate analyses to adjust for potential confounders.
Main Results:
- Leukocyte count strongly associated with smoking history, higher in males and white subjects than females and black subjects.
- In never-smokers, higher leukocyte count linked to poor health, obesity indices, and various cardiovascular risk factors.
- Inverse associations observed with high-density lipoprotein cholesterol, lung function, and physical activity.
Conclusions:
- Leukocyte count is associated with multiple cardiovascular risk factors, potentially reflecting subclinical disease or a causal role.
- Sociodemographic factors like smoking, sex, and race influence leukocyte count, but these effects are modified by other risk factors.
- The relationship between leukocyte count and cardiovascular disease may be complex and influenced by confounding variables.
Abstract:
Cross-sectional associations between leukocyte count and sociodemographic and cardiovascular risk factors were investigated in 14,679 participants aged 45-64 years in the Atherosclerosis Risk in Communities Study carried out in four US communities in 1986-1989. Leukocyte count was strongly associated with present or past history of cigarette smoking and was higher in males than in females and in white subjects than in black subjects. Among never smokers, no sex differences were evident after adjustment for other risk factors. Race-associated differences were substantially reduced after other factors were taken into account in multivariate analyses. In never smokers, leukocyte count was higher in those who reported poor health, and it was inversely associated with high density lipoprotein cholesterol, forced expiratory volume at 1 second, physical activity, and, among whites, height and socioeconomic indicators. It was directly associated with indices of body weight and body fat, heart rate, blood pressure, hemoglobin, platelet count, uric acid, fasting insulin and glycemia, triglycerides, fibrinogen, antithrombin III, protein C, factors VII and VIII, and von Willebrand factor. The associations of leukocyte count with cardiovascular risk factors may either represent manifestation of subclinical disease or suggest that leukocyte count is part of the causal chain leading to atherosclerosis. Alternatively, the relation of leukocyte count to cardiovascular disease may be confounded by risk factors and thus be noncausal.