The particular interactions of the traditional cardiovascular risk factors with different circulating specific leukocyte subtype counts in blood: an observational study

Abstract

Objective: The pathogenesis of atherosclerosis is multifactorial, however the impact of inflammatory cells in this process is well known. Different traditional cardiovascular risk factors (CVRFs) may have specifically different effects on leukocyte subtype. Thus, these special interactions may induce different vascular involvement forms due to the altered endothelial damage and vascular repair mechanisms. The aim of the present study was to investigate whether there is any specific relationship between the leukocyte subtypes and the traditional CVRFs and to evaluate the independency of possible relationships. Methods: The study had a cross-sectional observational design. The study population consisted of the patients who underwent coronary angiography with a suspicion of coronary artery disease (CAD) at our institution in an outpatient manner. We enrolled 677 consecutive eligible patients with CAD or normal coronary arteries (NCA) and investigated the associations of traditional CVRFs, demographic properties and biochemical parameters including fasting plasma glucose (FPG), creatinine, serum uric acid level (SUA) and lipids with total circulating inflammatory cell (WBC, leukocytes) and subtype counts including neutrophils (N), lymphocytes (L) and monocytes (M). As a dependent variable, total leukocyte count and subtypes, and neutrophil/lymphocyte ratio (N/L ratio) which has been found to being related with increased vascular risk and events were investigated in the groups determined by the presence or absence of CVRFs and CAD by the univariate analyses and then multiple linear regression analyses. Results: When we performed multiple linear regression analyses to determine the independent associations of inflammatory cell subtypes, we have found that FPG had an independent incremental association with WBC (β±SE:4.2±1.4, p=0.004) and N (β±SE:4.2±1.2, p=0.001). Current smoking had an independent incremental association with WBC and all cell subtypes (for WBC, N, L, and M: β±SE: 748±161, p<0.001; β±SE: 556±136, p<0.001; β±SE: 185±69, p=0.007; β±SE: 38±20, p=0.061, respectively) and SUA had an independent incremental association with WBC (β±SE: 115±43, p=0.008), N (β±SE: 107±38, p=0.005) and M (β±SE: 26±6, p<0.001). Hypertension had an independent incremental association with WBC (β±SE: 431±140, p=0.002) and N (β±SE: 315±118, p=0.008). Male gender had an independent incremental association with only M (β±SE: 52±20, p=0.010). Family history of CAD had an independent decremental association with WBC (β±SE: -327±139, p=0.019) and N (β±SE: -326±121, p=0.007). Finally, age had an independent decremental association with WBC (β±SE: -32±7, p<0.001) and L (β±SE: -16±3, p<0.001). The N/L ratio was independently related with increased age (p<0.001), FPG (p=0.003) and SUA (p=0.012). Conclusion: Our study results demonstrate that leukocyte subtypes have different specific associations with traditional CVRFs. We found that FPG affects specifically N while SUA affects specifically N and M, and current smoking affects nonsp...

Behaviour of the neutrophil to lymphocyte ratio in young subjects with acute myocardial infarction

“…As it is known, leukocytes play a pivotal role in atherosclerosis development because their activation is associated with impaired rheological properties, increased expression of adhesion molecules, and overproduction of cytokines, proteolytic enzymes and reactive oxygen species (ROS) [25]. Leukocyte subtypes are correlated with some cardiovascular risk factors: glucose level and arterial hypertension were correlated with neutrophils, uric acid with neutrophils and monocytes, while smoking affected all the subtypes [28]. An elevated neutrophil count correlates with higher risk of ischemic events [26] and with AMI mortality [37].…”

Correlation between the High Density Lipoprotein and its Subtypes in Coronary Heart Disease

“…The EPIC-Norfolk study [22] found that the average diameter decrease of HDL was related with the risk increases of CHD. Kocaman [23] found that cardiovascular protection function of HDL2 was stronger compared with HDL3, HDL2 decline in patients with was more evident. This paper divided HDL into 10 subtypes (HDL1-HDL 10) using Lipoprint HDL lipoprotein analyzer, 1-3 types were large particle types (HDL L ), 4-7 types were intermediate particle types (HDL M ), 8-10 types were small particle types (HDL S ).…”

Association between the neutrophil to lymphocyte ratio and prehypertension

“…The PHT designation serves to identify individuals who are potentially at higher risk for developing hypertension (HT) compared to those with optimal BP (< 120/80 mm Hg) (2,3). In the past few years, several prospective and cross-sectional studies have reported an elevated risk of coronary vascular disease (e.g., coronary heart disease and myocardial infarction) in prehypertensive subjects (4)(5)(6)(7)(8). Thus, it is important to understan the pathogenesis of PHT, as PHT may be the fi rst sign of cardiovascular disease (CVD) in some cases.…”

“…Elevated levels of systemic infl ammatory markers have been found to be associated with the incidence of cardiovascular diseases, such as coronary artery disease, HT, and atrial fi brillation (4,5,11). White blood cell (WBC) count and its subtypes are related to enhanced cardiovascular risk factors (6,12).…”