Zhang Hong-Mei, Li Xiao-Yong, Lin Ning, Niu Yi-Xin, Gu Hong-Xia, Lu Shuai, Yang Zhen, Qin Li, Su Qing
Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, China.
Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University (Chongming Branch), Shanghai, 202150, China.
Curr Med Sci. 2022 Apr;42(2):327-332. doi: 10.1007/s11596-022-2541-4. Epub 2022 Mar 15.
Atherosclerosis is considered a chronic inflammatory condition. The immune system is a key mediator in the initiation and progression of atherosclerosis. In a previous study, we found that the immune system was activated in diabetes and that total white blood cell (WBC) counts were elevated significantly in diabetic patients. To investigate whether WBC subtype counts in newly diagnosed diabetes are risk factors for future cardiovascular disease (CVD) events, we conducted a prospective population-based cohort study.
A total of 1498 newly diagnosed diabetic patients aged 40 to 70 years old were followed up for three years. Participants with previous CVD history and abnormal WBC counts were excluded. CVD events were recorded during follow-up.
We found that the baseline lymphocyte counts were independently associated with cardiovascular events during follow-up, with the Exp (β) (95% CI) at 1.749 (1.084-2.821). Lymphocyte count ≥2.9 (10/L) was significantly associated with the development of CVD (HR, 2.29; 95% CI, 1.12-4.67). The corresponding incidence of CVD per 1000 person-year for the lymphocyte count ≤2.8 (10/L) and lymphocyte count ≥2.9 (10/L) groups were 11.26 and 26.38, respectively.
We concluded that even in a normal range, higher lymphocyte levels may result in a significantly higher CVD risk among diabetic patients. Lymphocyte count ≥2.9 (10/L) is an independent predictor of developing future CVD events.
动脉粥样硬化被认为是一种慢性炎症性疾病。免疫系统是动脉粥样硬化发生和发展的关键介质。在先前的一项研究中，我们发现糖尿病患者的免疫系统被激活，且糖尿病患者的白细胞（WBC）总数显著升高。为了研究新诊断糖尿病患者的白细胞亚型计数是否为未来心血管疾病（CVD）事件的危险因素，我们进行了一项基于人群的前瞻性队列研究。
对总共1498名年龄在40至70岁的新诊断糖尿病患者进行了三年的随访。排除有既往心血管疾病史和白细胞计数异常的参与者。随访期间记录心血管疾病事件。
我们发现基线淋巴细胞计数与随访期间的心血管事件独立相关，Exp(β)（95%CI）为1.749（1.084 - 2.821）。淋巴细胞计数≥2.9（10⁹/L）与心血管疾病的发生显著相关（HR，2.29；95%CI，1.12 - 4.67）。淋巴细胞计数≤2.8（10⁹/L）组和淋巴细胞计数≥2.9（10⁹/L）组每1000人年的心血管疾病相应发病率分别为11.26和26.38。
我们得出结论，即使在正常范围内，较高的淋巴细胞水平可能导致糖尿病患者发生心血管疾病的风险显著更高。淋巴细胞计数≥2.9（10⁹/L）是未来发生心血管疾病事件的独立预测因素。
