Loimaala Antti, Rontu Riikka, Vuori Ilkka, Mercuri Michele, Lehtimäki Terho, Nenonen Arja, Bond M Gene
Clinical Physiology and Nuclear Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220 Seinäjoki, Finland.
Atherosclerosis. 2006 Oct;188(2):363-9. doi: 10.1016/j.atherosclerosis.2005.11.021. Epub 2005 Dec 27.
Leukocytosis is known to predict future cardiovascular events even in subjects without coronary heart disease (CHD), but its association with early atherosclerotic changes has remained less certain. The aim of the present study was to investigate how the blood leukocyte count compares with several other risk factors for CHD in determining carotid artery intima-media thickness (IMT) and subclinical carotid atherosclerosis in a population sample. Both carotid arteries were investigated with high-resolution B-mode ultrasound in a community-based sample of 219 randomly selected men aged 50-59 years to calculate the mean maximum IMT (MMax IMT) of 12 standard sites. Risk factor assessment included several traditional biochemical risk factors, blood pressure, maximal oxygen consumption and work load on ergometry, life-style habits and hematologic parameters. As genetic determinants, apolipoprotein E and A-IV polymorphisms were studied. According to multivariate regression analysis, age (P<0.0001), blood leukocyte count (P<0.0001) and systolic blood pressure (P<0.042) were the only significant predictors of MMax IMT. MMax IMT increased linearly from the lowest tertile of blood leukocyte count (1.14+/-0.20mm) to the second (1.18+/-0.25 mm) and to the highest tertile (1.25+/-0.27 mm, P=0.019). This difference remained significant after adjustment with age, systolic blood pressure and smoking (P=0.032). Leukocytes seem to have an independent role in the early arterial damage and they may reflect subclinical disease. This implies that leukocyte count is undervalued in the diagnostics and prognostics of carotid atherosclerosis.
众所周知，即使在没有冠心病（CHD）的受试者中，白细胞增多也可预测未来心血管事件，但其与早期动脉粥样硬化改变的关联仍不太明确。本研究的目的是在一个人群样本中，调查血液白细胞计数与冠心病的其他几个危险因素相比，在确定颈动脉内膜中层厚度（IMT）和亚临床颈动脉粥样硬化方面的情况。在一个以社区为基础的样本中，对219名年龄在50至59岁之间随机选取的男性进行了高分辨率B型超声检查，以测量双侧颈动脉，计算12个标准部位的平均最大IMT（MMax IMT）。危险因素评估包括几个传统的生化危险因素、血压、最大耗氧量和测力计上的工作量、生活方式习惯以及血液学参数。作为遗传决定因素，研究了载脂蛋白E和A-IV多态性。根据多变量回归分析，年龄（P<0.0001）、血液白细胞计数（P<0.0001）和收缩压（P<0.042）是MMax IMT的仅有的显著预测因素。MMax IMT从血液白细胞计数最低三分位数（1.14±0.20mm）到第二三分位数（1.18±0.25mm）再到最高三分位数（1.25±0.27mm，P=0.019）呈线性增加。在对年龄、收缩压和吸烟进行校正后，这种差异仍然显著（P=0.032）。白细胞似乎在早期动脉损伤中具有独立作用，并且它们可能反映亚临床疾病。这意味着白细胞计数在颈动脉粥样硬化的诊断和预后评估中未得到充分重视。
