Kim Jung Hee, Lim Soo, Park Kyong Soo, Jang Hak Chul, Choi Sung Hee
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
PLoS One. 2017 Jul 28;12(7):e0180332. doi: 10.1371/journal.pone.0180332. eCollection 2017.
Inflammation is a key mechanism of atherosclerosis. White blood cells (WBCs) play a pivotal role in the inflammatory process. We investigated the relationships between total and differential WBC counts and multi-detector cardiac computed tomography (MDCT) findings, as well as the risk of cardiovascular disease in asymptomatic patients in Korea.
We recruited asymptomatic men (n = 7274) and women (n = 5478) aged ≥30 years who were free of known coronary heart disease. All patients underwent MDCT during a routine health check-up in the Seoul National University Bundang Hospital between 2006 and 2007, and were followed-up for 5.6 years. We reviewed medical records for cardiovascular diseases (CVDs) and covariates.
In covariate-adjusted logistic regression models for MDCT findings, subjects within the third tertile of all WBC subtypes had a higher risk for significant stenosis and noncalcified plaques compared with the first tertile of each subtype. In Cox proportional hazard regression models for the risk of CVDs, subjects within the third tertiles of lymphocytes and monocytes were at an increased risk of CVDs (total WBC, HR = 1.22 [1.02-1.44]; lymphocyte, HR = 1.47 [1.25-1.74]; monocytes, HR = 1.26 [1.02-1.35]) even after further adjustment for covariates and coronary artery stenosis.
Total WBC counts were related with the severity of coronary artery disease, and higher WBC counts increased the risk of CVDs in asymptomatic Koreans mainly by virtue of monocytes.
炎症是动脉粥样硬化的关键机制。白细胞（WBCs）在炎症过程中起关键作用。我们研究了韩国无症状患者的白细胞总数及分类计数与多排心脏计算机断层扫描（MDCT）结果之间的关系，以及心血管疾病风险。
我们招募了年龄≥30岁、无已知冠心病的无症状男性（n = 7274）和女性（n = 5478）。所有患者于2006年至2007年在首尔国立大学盆唐医院进行常规健康检查时接受了MDCT检查，并随访5.6年。我们查阅了心血管疾病（CVDs）和协变量的医疗记录。
在针对MDCT结果的协变量调整逻辑回归模型中，所有白细胞亚型处于第三个三分位数的受试者与每个亚型的第一个三分位数相比，发生显著狭窄和非钙化斑块的风险更高。在针对CVDs风险的Cox比例风险回归模型中，淋巴细胞和单核细胞处于第三个三分位数的受试者发生CVDs的风险增加（白细胞总数，HR = 1.22 [1.02 - 1.44]；淋巴细胞，HR = 1.47 [1.25 - 1.74]；单核细胞，HR = 1.26 [1.02 - 1.35]），即使在进一步调整协变量和冠状动脉狭窄后也是如此。
白细胞总数与冠状动脉疾病的严重程度相关，较高的白细胞计数主要通过单核细胞增加了韩国无症状人群发生CVDs的风险。
