Smith Megan R, Kinmonth Ann-Louise, Luben Robert N, Bingham Sheila, Day Nicholas E, Wareham Nicholas J, Welch Ailsa, Khaw Kay-Tee
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 2SR, UK.
Atherosclerosis. 2003 Aug;169(2):331-7. doi: 10.1016/s0021-9150(03)00200-4.
The total white blood cell (WBC) count is reported to be an independent predictor of mortality in several prospective studies. We investigated the association between total and differential WBC counts and cigarette smoking habit in a cross-sectional population-based study of 6902 men and 8405 women 39-79 years of age participating between July 1994 and 1997 in the European Prospective Investigation of Cancer (EPIC-Norfolk) study. Main outcome measures included WBC, granulocyte, lymphocyte and monocyte counts measured at a baseline health check and self-reported cigarette smoking habit. The age- and body mass index-adjusted mean total WBC counts were 7.8, 6.4, and 6.2x10(3) per ul (P<0.0001) among male current, former and never smokers, respectively, and 7.4, 6.3 and 6.2x10(3) per ul (P<0.0001), respectively, in women. The greatest absolute and percentage differences between smoking groups were observed for the granulocyte count. Current smoking habit had a stronger effect on mean total WBC counts than cumulative exposure as measured by pack years. Among former smokers mean age- and body mass index-adjusted WBC, granulocyte and lymphocyte counts were inversely related to duration of smoking cessation (P< or =0.02). Smokers who had given up less than 12 months previously had WBC counts substantially lower (6.7 and 6.9x10(3) per ul, respectively, in men and women) than current smokers. In conclusion, the total WBC count and its components (particularly the granulocyte count) are strongly associated with cigarette smoking habit. Smoking cessation may have an almost immediate impact at least on pathophysiologic processes such as inflammation that may be indicated by the WBC count. The apparent almost immediate reversibility of effects of smoking on inflammation, as indicated by the WBC count, may help motivate efforts to stop smoking.
在几项前瞻性研究中，总白细胞（WBC）计数据报道是死亡率的一个独立预测指标。我们在一项基于人群的横断面研究中，调查了6902名男性和8405名39至79岁女性的总白细胞计数及分类计数与吸烟习惯之间的关联，这些研究对象于1994年7月至1997年参与了欧洲癌症前瞻性调查（EPIC - 诺福克）研究。主要观察指标包括在基线健康检查时测量的白细胞、粒细胞、淋巴细胞和单核细胞计数以及自我报告的吸烟习惯。在男性当前吸烟者、既往吸烟者和从不吸烟者中，经年龄和体重指数调整后的平均总白细胞计数分别为每微升7.8、6.4和6.2×10³（P<0.0001），在女性中分别为每微升7.4、6.3和6.2×10³（P<0.0001）。在粒细胞计数方面，吸烟组之间观察到最大的绝对差异和百分比差异。当前吸烟习惯对平均总白细胞计数的影响比以包年衡量的累积暴露更强。在既往吸烟者中，经年龄和体重指数调整后的白细胞、粒细胞和淋巴细胞平均计数与戒烟持续时间呈负相关（P≤0.02）。戒烟不到12个月的吸烟者的白细胞计数（男性和女性分别为每微升6.7和6.9×10³）显著低于当前吸烟者。总之，总白细胞计数及其组成部分（特别是粒细胞计数）与吸烟习惯密切相关。戒烟可能至少对诸如炎症等病理生理过程产生几乎即时的影响，而白细胞计数可能表明这些过程。白细胞计数所表明的吸烟对炎症影响的明显几乎即时的可逆性，可能有助于激发戒烟的努力。
