Tianjin Medical University General Hospital.
Department of Hematology, Tianjin Medical University General Hospital.
J Atheroscler Thromb. 2023 Oct 1;30(10):1492-1506. doi: 10.5551/jat.63887. Epub 2023 Feb 16.
To examine the trajectory of white blood cell (WBC) and their potential impacts on cardiovascular disease (CVD) and all-cause mortality (ACM) risks.
This prospective cohort included 61,666 participants without CVD on or before June 1, 2012. Latent mixture modeling was used to identify WBC trajectories in 2006-2012 as predictors of CVD and ACM. Incident CVD and ACM in 2012-2019 were the outcomes. Cox proportional hazards models were fitted to analyze the risks of incident CVD and ACM.
According to WBC ranges and dynamics, five distinct WBC trajectories were identified: low-stable (n=18,432), moderate-stable (n=26,656), elevated-stable (n=3,153), moderate-increasing (n=11,622), and elevated-decreasing (n=1,803). During 6.65±0.83 years of follow-up, we documented 3773 incident CVD cases and 3304 deaths. Relative to the low-stable pattern, the moderate-increasing pattern was predictive of an elevated risk of CVD (HR=1.36, 95% CI: 1.24-1.50), especially acute myocardial infarction (AMI) (HR=1.91, 95% CI: 1.46-2.51), while the elevated-stable pattern was predictive of an elevated risk of ACM (HR=1.77, 95% CI: 1.52-2.06). Among participants with hs-CRP ＜2 mg/L or ≥2 mg/L, similar associations were observed between the moderate-increasing pattern with CVD (HR=1.41, 95% CI: 1.24-1.61) and ACM (HR=1.54, 95% CI: 1.18-2.01, HR=1.89, 95% CI: 1.57-2.29, respectively).
We found that distinct WBC trajectories were differentially associated with CVD and ACM risks in Chinese adults.
探讨白细胞（WBC）的轨迹及其对心血管疾病（CVD）和全因死亡率（ACM）风险的潜在影响。
本前瞻性队列研究纳入了 2012 年 6 月 1 日前无 CVD 的 61666 名参与者。采用潜在混合模型识别 2006-2012 年的 WBC 轨迹，作为 CVD 和 ACM 的预测指标。2012-2019 年发生的 CVD 和 ACM 为结局事件。采用 Cox 比例风险模型分析 CVD 和 ACM 的发病风险。
根据 WBC 范围和动态，确定了 5 种不同的 WBC 轨迹：低稳定型（n=18432）、中稳定型（n=26656）、升高稳定型（n=3153）、中增型（n=11622）和升高下降型（n=1803）。在 6.65±0.83 年的随访期间，我们记录了 3773 例 CVD 事件和 3304 例死亡。与低稳定型相比，中增型预示着 CVD 的风险增加（HR=1.36，95%CI：1.24-1.50），尤其是急性心肌梗死（HR=1.91，95%CI：1.46-2.51），而升高稳定型预示着 ACM 的风险增加（HR=1.77，95%CI：1.52-2.06）。在 hs-CRP＜2mg/L 或≥2mg/L 的参与者中，中增型与 CVD（HR=1.41，95%CI：1.24-1.61）和 ACM（HR=1.54，95%CI：1.18-2.01，HR=1.89，95%CI：1.57-2.29）的风险之间也存在类似的关联。
我们发现，不同的 WBC 轨迹与中国成年人的 CVD 和 ACM 风险存在差异相关。
