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白细胞计数与中风和冠心病风险:社区中的循环风险研究(CIRCS)。

Leukocyte Count and Risks of Stroke and Coronary Heart Disease: The Circulatory Risk in Communities Study (CIRCS).

机构信息

Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University.

Osaka Center for Cancer and Cardiovascular Diseases Prevention.

出版信息

J Atheroscler Thromb. 2022 Apr 1;29(4):527-535. doi: 10.5551/jat.60889. Epub 2021 Mar 21.

Abstract

AIM

This study aimed to investigate the associations of leukocyte count with the risks of stroke and coronary heart disease among the general Japanese population.

METHODS

A total of 5,242 residents aged 40-69 years living in two Japanese communities underwent leukocyte count measurements between 1991 and 2000, and the data were updated using 5- or 10-year follow-ups or both. Participants who had histories of stroke, coronary heart disease, or high values of leukocyte count (>130×10 cells/mm) were excluded. Hazard ratios with 95% confidence intervals (CIs) were calculated according to quartiles of cumulative average leukocyte count.

RESULTS

During follow-up of 21 years, 327 stroke and 130 coronary heart disease cases were determined. After adjustments for age, sex, community, and updated cardiovascular risk factors, the multivariable hazard ratio (95% CI) for the highest versus lowest quartile of leukocyte count was 1.50 (1.08-2.08) for ischemic stroke, 1.59 (1.00-2.51) for lacunar infarction, 1.42 (0.90-2.26) for non-lacunar infarction, 2.17 (1.33-3.55) for coronary heart disease, and 1.40 (1.11-1.76) for total cardiovascular disease. In smoking status-stratified analyses, the corresponding multivariable hazard ratio (95% CI) was 2.45 (1.11-5.38) for ischemic stroke, 2.73 (1.37-5.44) for coronary heart disease in current smokers, 2.42 (1.07-5.46), 1.55 (0.58-4.15) in former smokers, and 1.17 (0.75-1.82), 1.78 (0.83-3.82) in never smokers.

CONCLUSION

Leukocyte count was positively associated with the risks of ischemic stroke and coronary heart disease among the general Japanese population, especially in current smokers.

摘要

目的

本研究旨在探讨白细胞计数与普通日本人群中风和冠心病风险的关系。

方法

共有 5242 名年龄在 40-69 岁的居民居住在两个日本社区,在 1991 年至 2000 年间进行了白细胞计数测量,并通过 5 年或 10 年的随访或两者结合进行了数据更新。排除了有中风、冠心病或白细胞计数高(>130×10 个细胞/mm)病史的参与者。根据累积平均白细胞计数的四分位间距,计算风险比及其 95%置信区间(CI)。

结果

在 21 年的随访期间,确定了 327 例中风和 130 例冠心病病例。在校正年龄、性别、社区和更新的心血管危险因素后,白细胞计数最高与最低四分位间距的多变量风险比(95%CI)为缺血性中风 1.50(1.08-2.08),腔隙性梗死 1.59(1.00-2.51),非腔隙性梗死 1.42(0.90-2.26),冠心病 2.17(1.33-3.55),以及总心血管疾病 1.40(1.11-1.76)。在吸烟状况分层分析中,相应的多变量风险比(95%CI)为缺血性中风 2.45(1.11-5.38),冠心病 2.73(1.37-5.44),当前吸烟者 2.42(1.07-5.46),前吸烟者 1.55(0.58-4.15),从不吸烟者 1.17(0.75-1.82),1.78(0.83-3.82)。

结论

白细胞计数与普通日本人群中风和冠心病风险呈正相关,尤其是在当前吸烟者中。

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