An epidemiological study on the association between the total leukocyte and neutrophil counts, and risk factors of ischemic heart disease by smoking status in Japanese factory workers

Leukocyte-related parameters in older adults with metabolic syndrome

PURPOSE

We aimed to examine the association between leukocyte-related parameters and the risk of metabolic syndrome (MetS) in community-dwelling older Chinese adults, with a special focus on assessing the diagnostic ability of leukocyte-related parameters in detecting MetS and the potential interaction effect of sex in the leukocyte-MetS relationship.

METHODS

Study sample was from the Weitang Geriatric Diseases Study, which included 4579 individuals aged 60 years or above. MetS was diagnosed based on the Adult Treatment Panel III criteria. Leukocyte-related parameters were assessed using an automated hematology analyzer.

RESULTS

The adjusted odds ratio (95% confidence interval (CI)) of MetS for the highest quartile of leukocyte-related parameters (leukocyte, lymphocyte, neutrophil, monocyte, eosinophil, and basophil), when compared with the lowest quartile were 2.87 (2.30, 3.59), 2.69 (2.15, 3.36), 2.09 (1.67, 2.62), 2.12 (1.71, 2.64), 1.62 (1.31, 2.00), and 1.36 (1.11, 1.65), respectively. Adding leukocyte, lymphocyte, monocyte, and neutrophil to a model containing conventional risk factors improved risk prediction for MetS. Furthermore, significant interactions between leukocyte, monocyte, neutrophil, and sex on MetS were observed (all P value for interaction <0.01).

CONCLUSION

The numbers of total leukocytes, lymphocyte, monocyte, neutrophil, and eosinophil counts were elevated in older adults with MetS, suggesting that leukocyte-related parameters may be meaningful biomarkers for MetS. Adding leukocyte-related parameters to the conventional models increased the ability of predicting MetS among older adults. These parameters may be useful biomarkers for further risk appraisal of MetS in older adults.

The Effects of Firsthand and Secondhand Cigarette Smoking on Immune System Cells and Antibodies in Saudi Arabian Males

Firsthand and, to a lesser degree, secondhand tobacco smoking are considered the greatest causes of preventable illnesses and premature death worldwide. Firsthand and secondhand smoking have adverse consequences on the immune system, although these effects are not fully understood. A few serological studies have been done on firsthand and secondhand smokers in Saudi Arabia. The present study investigates the effects of firsthand and secondhand smoking on the immune system of randomly chosen male firsthand (50 subjects) and secondhand (50 subjects) cigarette smokers, residing in Jeddah, Saudi Arabia, with an age range of 20-40 years. Firsthand smokers were categorized according to the number of cigarettes smoked daily (frequency of smoking). Blood samples were collected and differential complete blood counts, cotinine concentrations, and antibodies (IgG, IgM, and IgA) concentrations were determined. Additionally, T, B, NK, CD4+ and CD8+ cells counts and percentages were determined. Compared to secondhand smokers, firsthand smokers showed a highly significantly higher mean cotinine concentration and a highly significantly lower mean IgA concentration. Additionally, Secondhand smokers had significantly higher mean lymphocyte count and CD4+/CD8+ ratio, and significantly lower mean basophil and NK cells counts. All other parameters showed no significant differences between firsthand and secondhand smokers and there were no differences between the frequency of smoking categories for the firsthand smokers. Therefore, The results show suggest that passive and active smoking have different immunological effects since IgA levels and some white blood cells counts were different in firsthand and secondhand smokers.

Effects of X-rays and cigarette smoking on leukocyte, lymphocyte and mitotic index values and SCE rates: the relationship between mitotic index and lymphocyte count

Many previous studies revealed that smoking increases leukocyte and lymphocyte counts while exposure to X-rays decreases these counts. However the relationships between lymphocyte life span and smoking as well as X-rays were not well documented. The primary aim of this study was to determine relationships between smoking X-rays (in combination and individually) and life span of lymphocytes. Blood samples from 200 healthy individuals, half of which were X-ray exposed individuals, were collected. Half of X-ray exposed and of non-X-ray exposed individuals were smokers. There were equal numbers of male and female participants. Two lymphocyte cultures, one for the sister chromatid exchange (SCE) analysis and the other for the determination of mitotic index values were prepared using one part of the blood samples collected from the individuals. From the other part of the blood sample leukocyte and lymphocyte counts were determined with a haemogram device. Evaluation of the findings suggested that leukocyte count, lymphocyte count, mitotic index were relatively lower for the X-ray exposed individuals. In addition these values were higher for smokers than nonsmokers in general. The highest SCE rates were recorded for smoking radiology technicians. The most important finding is that lymphocyte life span is relatively low in smokers and in X-ray exposed males.

Do circulating blood cell types correlate with modifiable risk factors and outcomes in patients with acute coronary syndrome (ACS)?

AIMS

Atherosclerosis is an inflammatory process with different cardiovascular risk factors (CVRFs) contributing to its pathogenesis. We aimed to evaluate the specific relationship between circulating blood leukocytes, troponin I and CVRFs.

METHODS

We prospectively enrolled 959 patients with evidence of acute coronary syndrome either in form of unstable angina or STEMI or NSTEMI. Details demographic characteristics, CVRF and biochemical parameters such as total white blood cells (WBC), neutrophil, lymphocytes, platelet, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and troponin I were collected.

RESULTS

The results indicated that patients having either hypertension, diabetes or smoking habit had significantly higher levels of total WBC (p=0.013), neutrophil (p=0.029), NLR (p=0.029) and PLR (p=0.009). The level of troponin I was unaffected by these risk factors. Significant association of hypertension was found with total WBC (p=0.0392), lymphocytes (p=0.0384) and PLR (p=0.0027), whereas in diabetes and females all other leukocyte subtypes were significantly altered except for platelet and troponin I. Smokers had higher level of total WBC count (p=0.0033) and PLR (p=0.0464). No relationship between CVRFs and leukocytes was observed in males. The age independent effect was observed with PLR, whereas association with total WBC, lymphocytes, NLR, platelet was specific in older population. In younger patients NLR (p=0.0453) is more likely to be elevated. Mortality was significantly associated with changes in the leukocytes but not with the CVRF presence.

CONCLUSION

We demonstrate that the neutrophils, lymphocytes and total WBC along with its ratios predict mortality and are more likely to be elevated in presence of CVRFs.

White blood cell count in young adulthood and coronary artery calcification in early middle age: coronary artery risk development in young adults (CARDIA) study

White blood cell (WBC) count is associated with incident coronary heart disease (CHD). Data are sparse regarding its association in young adults with future coronary artery calcification (CAC). Our study was conducted among coronary artery risk development in young adults (CARDIA) participants (n=3,094). We examined the association between baseline (Y0) WBC counts and CHD risk factors using linear regression models. We further assessed prospective associations between Y0 WBC and inflammatory biomarkers during the follow-up, and the presence of CAC 15 and 20 years later. In total, 272 and 566 subjects had CAC scores>0 at year (Y) 15 and Y20, respectively. Baseline total WBC counts were cross-sectionally associated with SBP, BMI, and smoking, or HDL-cholesterol (p≤0.01) at Y0, and prospectively associated with C-reactive protein at Y7, Y15, and Y20, and fibrinogen at Y5 and Y20 (p<0.01). After adjustment for potential confounding factors, baseline neutrophil count was borderline associated with CAC presence 15 years later (OR=1.18 per unit, 95% CI 1.00-1.44) and total WBC (OR=1.07, 95% CI 0.96-1.19) or eosinophil (OR=1.12, 95%CI 1.00-1.25) was borderline associated with CAC presence at Y20. Baseline total WBC counts in young adults was associated prospectively with CAC presence 20 years later after adjusting for age, sex, and race. Results are attenuated when other risk factors are accounted for. Our results suggest the possible early involvement of WBC, particularly eosinophils, in the early stages of atherosclerosis.

Longitudinal study on white blood cell count and the incidence of metabolic syndrome

OBJECTIVE

Many studies have revealed that white blood cell count (WBC) is related to insulin resistance which is a central mechanism of metabolic syndrome (MetS). However, few cohort studies have examined the role of WBC in the development of MetS. We hypothesized that WBC is associated with the future development of MetS, and investigated the longitudinal incidence of MetS in healthy workers.

METHODS

WBC was measured in 5,073 workers (mean age 42.5 years) without MetS at baseline. The incidence of MetS was monitored over 7 years of follow-up, in relation to quartiles of WBC. During the follow-up, 925 participants were diagnosed as MetS.

RESULTS

Incidence of MetS was increased in participants with higher WBC: the rates of incidence of MetS were 22.6, 32.9, 42.9, and 57.5 per 1,000 person-years of follow-up in the 1st, 2nd, 3rd, and 4th quartiles of WBC, respectively. After adjustments for confounding factors, the adjusted hazards ratio (95% confidence interval) for MetS was 1.00 (reference), 1.22 (0.98 to 1.51), 1.52 (1.24 to 1.87), and 1.66 (1.35 to 2.04) through the quartiles of WBC, respectively, (p <0.001). This relationship was consistent among current smokers and never smokers, and among male and female genders, respectively.

CONCLUSION

WBC is useful in predicting the future development of MetS which leads to atherosclerotic diseases.

Association between cigarette smoking, white blood cell count, and metabolic syndrome as defined by the Japanese criteria

OBJECTIVE

Cigarette smoking increases the circulating white blood cell (WBC) count and the prevalence of metabolic syndrome. We investigated the association between cigarette smoking, WBC count, and metabolic syndrome as defined by the Japanese criteria.

METHOD

Cross-sectional data from 3,687 men undergoing general health screening between 2005 and 2006 were analyzed.

RESULTS

After adjustment for age and total cholesterol, former and current smoking were associated with the highest WBC quartile (>or=6.3 x 10(3) cells/muL) with an odds ratio of 1.35 (95% CI 1.09-1.66, P=0.0055) and 4.45 (95% CI 3.69-5.37, P<0.0001), respectively. It was found that increased WBC count was a risk factor for metabolic syndrome; on the other hand, the current smoking was not found to be a predictor for metabolic syndrome, when each WBC count quartile was separately analyzed.

CONCLUSIONS

Our data suggest that the risk for MetS, defined by Japanese criteria, might be estimated by the WBC count in Japanese men irrespective of their smoking status, although it should also be noted that the cigarette smoking increases the number of circulating WBC count.

Immune function biomarkers in children exposed to lead and organochlorine compounds: a cross-sectional study

BACKGROUND

Different organochlorines and lead (Pb) have been shown to have immunomodulating properties. Children are at greater risk for exposure to these environmental toxicants, but very little data exist on simultaneous exposures to these substances.

METHODS

We investigated whether the organochlorine compounds (OC) dichlorodiphenylethylene (DDE), hexachlorobenzene (HCB), hexachlorocyclohexane (gamma-HCH), the sum of polychlorinated biphenyls (SigmaPCBs) and Pb were associated with immune markers such as immunoglobulin (Ig) levels, white blood cell (WBC), counts of lymphocytes; eosinophils and their eosinophilic granula as well as IgE count on basophils. The investigation was part of a cross-sectional environmental study in Hesse, Germany. In 1995, exposure to OC and Pb were determined, questionnaire data collected and immune markers quantified in 331 children. For the analyses, exposure (OC and Pb) concentrations were grouped in quartiles (gamma-HCH into tertiles). Using linear regression, controlling for age, gender, passive smoking, serum lipids, and infections in the previous 12 months, we assessed the association between exposures and immune markers. Adjusted geometric means are provided for the different exposure levels.

RESULTS

Geometric means were: DDE 0.32 microg/L, SigmaPCBs 0.50 microg/L, HCB 0.22 microg/L, gamma-HCH 0.02 microg/L and Pb 26.8 microg/L. The SigmaPCBs was significantly associated with increased IgM levels, whereas HCB was inversely related to IgM. There was a higher number of NK cells (CD56+) with increased gamma-HCH concentrations. At higher lead concentrations we saw increased IgE levels. DDE showed the most associations with significant increases in WBC count, in IgE count on basophils, IgE, IgG, and IgA levels. DDE was also found to significantly decrease eosinophilic granula content.

CONCLUSION

Low-level exposures to OC and lead (Pb) in children may have immunomodulating effects. The increased IgE levels, IgE count on basophils, and the reduction of eosinophilic granula at higher DDE concentrations showed a most consistent pattern, which could be of clinical importance in the etiology of allergic diseases.