外周血白细胞计数水平与高血压风险相关性的meta分析

目的 系统评价外周血白细胞计数水平与高血压发生风险的关系。 方法 计算机检索中国知网、万方数据库、维普中文科技期刊数据库,Pubmed、Embase以及Cochrane Library数据库中公开发表的有关外周血白细胞计数与高血压发病风险的流行病学观察性研究,由2位研究者按照文献的纳入及排除标准独立进行文献的筛选,提取相关数据并采用纽卡斯尔-渥太华量表对纳入的文献质量进行评价。运用Stata 12.0软件进行meta分析。 结果 共纳入10篇文献,其中包括11项研究(7项队列研究,1项巢式病例对照研究,1项病例对照研究,2项横断面研究),共纳入研究对象96 285例,其中包括23 861例高血压患者。使用随机效应模型对各效应量进行合并。结果显示:外周血白细胞计数最高组发生高血压的风险较白细胞计数最低组高34%(RR=1.34, 95%CI: 1.21~1.48);白细胞计数每增加1×10⁹/L,高血压的发生风险增加6%(RR=1.06, 95%CI: 1.01~1.12)。 结论 外周血白细胞计数水平与高血压的发生风险相关,白细胞计数水平升高可增加高血压的发生风险。     

Associations between white blood cell count and features of the metabolic syndrome in Japanese male office workers

We assessed the association of white blood cell (WBC) count with different components of the metabolic syndrome (MS) in 5275 Japanese male office workers aged 23-59 years. There was a significantly crude correlation between WBC count and body mass index, systolic and diastolic blood pressures, total cholesterol, high-density lipoprotein cholesterol (negative), triglycerides, fasting plasma glucose, and uric acid (all P<0.001). After controlling for potential confounding factors, the adjusted means of WBC count were significantly higher in subjects with each feature of the MS (obesity, hypertension, hypercholesterolemia, low high-density lipoprotein cholesterol levels, hypertriglyceridemia, high fasting plasma glucose levels, and hyperuricemia) (all P<0.005). The adjusted WBC count increments in subjects with 1, 2, 3, 4, and > or = 5 features of the MS were 0.28, 0.45, 0.68, 0.76, and 1.40 x 10(9) cells/l, respectively, compared with the subjects without features of the MS (P for trend<0.001). The adjusted means of WBC count increased significantly with the increasing number of features of the MS in both non-smokers and smokers (both P<0.001). These data indicate a strong association between WBC count and a number of disorders characterizing the MS independent of cigarette smoking among Japanese men.     

健康体检人群白细胞计数与非酒精性脂肪肝的关联性研究

目的 探讨健康体检人群白细胞计数与非酒精性脂肪肝(non-alcoholic fatty liver disease, NAFLD)的关联性。 方法 对象为2016年1—12月中国医科大学附属第一医院健康体检中心的体检人群,对其临床资料进行回顾性分析。最终纳入29 729人,其中NAFLD 12 191例。采用Logistic回归模型评估白细胞计数不同四分位数水平与NAFLD患病之间的关系。 结果 调整混杂因素的影响后,以白细胞计数第一四分位数为参考,第二、三、四分位数组NAFLD患病的比值比(95%CI)分别为1.190(1.084,1.307),1.260(1.075,1.476)和1.430(1.221,1.675)(P_趋势性值<0.001)。 结论 健康体检人群白细胞计数与NAFLD存在相关关系。     

外周血白细胞与代谢综合征的相关性研究

目的探讨外周血白细胞(WBC)与代谢综合征的相关性。方法分析了336例门诊体检人员的吸烟、饮酒情况及代谢综合征的多项指标如腹围、体重指数、血压、血糖、血脂、尿酸水平与WBC的相关性。结果(1)代谢综合征组外周血WBC为(7.2±1.7)×109/L,明显高于非代谢综合征组的(6.5±1.6)×109/L。(2)吸烟、饮酒、腹围、体重指数、空腹血糖、收缩压、舒张压、低密度脂蛋白-胆固醇、甘油三酯、尿酸水平与WBC呈正相关,而高密度脂蛋白-胆固醇与之呈负相关。(3)WBC随着人群所含代谢综合征的组成成分个数的增多而上升。结论WBC与代谢综合征的多种组成成分具有明显的相关性。WBC不同程度的增高可以作为慢性亚临床炎症反应的表现,并能促进代谢综合征的发生与发展。     

Mortality among white and nonwhite farmers in North Carolina, 1976-1978

Death certificate information identified 9,245 white and 3,508 nonwhite men who died in North Carolina during 1976-1978 and who had been farmers. The distribution of deaths from various causes among these men was compared to that of other male decedents in the state. For both white and nonwhite farmers, proportional mortality ratios (PMRs) were elevated for tuberculosis (whites, 1.6; nonwhites, 1.7), diseases of the skin and subcutaneous tissue (whites, 2.5; nonwhites, 1.5), and external causes (whites, 1.2; nonwhites, 1.1) and were decreased for cancers of the esophagus (whites and nonwhites, 0.5) and large intestine and rectum (whites and nonwhites, 0.7). White farmers had an increased relative frequency of melanoma (PMR = 1.2) and other skin cancer (PMR = 1.8), while nonwhite farmers had an increased relative frequency of melanoma (PMR = 6.3), brain cancer (PMR = 2.3), and leukemia (PMR = 1.9). In addition, among decedents under 65 years of age, both white and nonwhite farmers had an elevated proportional mortality ratio for prostate cancer (whites, 1.6; nonwhites, 1.3). Many of these results are consistent with observations from other studies. Some of these findings, particularly those for nonwhites, warrant further evaluation, including detailed investigation of possibly related farming practices.     

White blood cell count and risk for all-cause, cardiovascular, and cancer mortality in a cohort of Koreans

The authors conducted a 10-year prospective cohort study of mortality in relation to white blood cell counts of 437,454 Koreans, aged 40-95 years, who received health insurance from the National Health Insurance Corporation and were medically evaluated in 1993 or 1995, with white blood cell measurement. The main outcome measures were mortality from all causes, all cancers, and all atherosclerotic cardiovascular diseases (ASCVD). Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards models with adjustment for age and potential confounders. During follow-up, 48,757 deaths occurred, with 15,507 deaths from cancer and 11,676 from ASCVD. For men and women, white blood cell count was associated with all-cause mortality and ASCVD mortality but not with cancer mortality. In healthy nonsmokers, a graded association between a higher white blood cell count and a higher risk of ASCVD was observed in men (highest vs. lowest quintile: hazard ratio = 2.10, 95% confidence interval: 1.50, 2.94) and in women (hazard ratio = 1.35, 95% confidence interval: 1.17, 1.56). In healthy smokers, a graded association between a higher white blood cell count and a higher risk of ASCVD was also observed in men (highest vs. lowest quintile: hazard ratio = 1.46, 95% confidence interval: 1.25, 1.72). These findings indicate that the white blood cell count is an independent risk factor for all-cause mortality and for ASCVD mortality.     

白细胞计数及其分类与妊娠期糖尿病的相关性

目的探讨白细胞计数及其分类与妊娠期糖尿病(GDM)的相关性。方法孕24~28周行糖耐量筛查,纳入GDM病例35例(GDM组),正常妊娠者70例(对照组),同时测定血清空腹胰岛素(FINS)、白细胞计数及其分类,详细记录受试者孕前体质量、身高,分析白细胞计数及其分类与GDM的相关性。结果 GDM组白细胞计数及其分类中的白细胞数、中性粒细胞数、淋巴细胞数、嗜碱性粒细胞数水平高于对照组,Pearson相关分析显示,FINS和胰岛素抵抗指数(HOMA-IR)均与白细胞数、中性粒细胞数、淋巴细胞数和嗜碱性粒细胞数呈正相关。结论 GDM与白细胞计数及其分类中的白细胞数、中性粒细胞数、淋巴细胞数和嗜碱性粒细胞数密切相关,这些因子可作为GDM基本预测的指标之一。     

Multiple risk factors and population attributable risk for ischemic heart disease mortality in the United States, 1971-1992

The objective of this study was to assess the associations and population attributable risks (PAR) of risk factor combinations and ischemic heart disease (IHD) mortality in the United States. We used logistic regression models to assess the association of risk factors with IHD in the First National Health and Nutrition Examination Survey (1971-1974) and Epidemiologic Follow-up Study (1982-1992) among white and black men and women. We examined eight modifiable risk factors: hypertension, elevated serum cholesterol, diabetes, overweight, current smoking, physical inactivity, depression, and nonuse of replacement hormones. Risk factors associated with IHD mortality were the same among white and black men (i.e., age, education, smoking, diabetes, hypertension, and serum cholesterol). Age, education, smoking, diabetes, and hypertension were the risk factors among white and black women. Physical inactivity, nonuse of replacement hormones, serum cholesterol, and overweight were the additional risk factors among white women. Adjusted for demographic risk factors, overall PARs for study risk factors were 41.2% for white men, 60.5% for white women (with five risk factors only), 49.2% for black men, and 71.2% for black women. Much IHD mortality attributable to individual risk factors is caused by those factors in combination with other risk factors; relatively little mortality is attributable to each risk factor in isolation. Analysis that does not examine risk factor combinations may greatly overestimate PARs associated with individual risk factors.     

脑出血预后与血白细胞数及血糖的关系分析

目的　分析脑出血预后与血白细胞数、血糖的关系。方法　测定５１ 例急性脑血管病中的脑出血患者，在起病４８ 小时内的外周血白细胞计数与血糖值。结果　外周血白细胞计数升高和血糖高于正常值者预后相对较差。结论　脑出血病死率与外周血白细胞计数和血糖值相关。     

Association between lifestyle and white blood cell count: a study of Japanese male office workers

METHODS: We assessed the association of lifestyle factors with white blood cell (WBC) count in 3681 Japanese male office workers aged 35-59 years. RESULTS: The WBC count differed significantly across lifestyle factors (overall obesity, alcohol consumption, cigarette smoking, eating breakfast, nutritional balance, physical exercise and hours of work). From multiple linear regression analyses, overall obesity, alcohol intake, cigarette smoking, nutritional balance and hours of work remained as statistically significant factors associated with WBC count. The WBC count increment showed a positive dose-response relationship with poor lifestyle factors regarding overall obesity, cigarette smoking and nutritional balance. On the other hand, the WBC count increment showed a negative dose-response relationship with alcohol intake and hours of work. CONCLUSION: These data indicate that lifestyle factors may exert an important effect on WBC count.     

Texaco Mortality Study: II. Patterns of mortality among white males by specific job groups

While an earlier report on the Texaco Mortality Study cohort showed no statistically significant elevations for any cause of death for the white males, it did not preclude any excess risk of mortality within subgroups of workers. In this study, an employee's complete job history was used to determine his work categories, and patterns of mortality were examined for the more common job categories. All of the job categories examined showed deficits for mortality overall, and the patterns seen were similar to those for the entire cohort. Significant elevations were seen in pancreas cancer mortality for office and managerial people and in leukemia mortality for pipefitters and boilermakers. Other elevations of particular interest based on five or more deaths were brain cancer for laboratory workers and benign neoplasms in pipefitters and boilermakers. These associations were examined by latency and years worked, and no consistently positive associations were seen. It was not possible to take into account calendar time of exposure in this type of analysis, nor could any specific chemicals or levels of exposure be associated with the job categories where the standardized mortality ratios were elevated.     

Dietary vitamin B-6 intake and food sources in the US population: NHANES II, 1976-1980

Dietary vitamin B-6 intake and food sources were estimated from the Second National Health and Nutrition Examination Survey (NHANES II) dietary data for 11,658 adults aged 19-74 y. The average daily intake of vitamin B-6 was 1.48 +/- 0.01 mg (mean +/- SEM) for the total population, 1.85 +/- 0.02 for males and 1.14 +/- 0.01 for females. Seventy-one percent of males and 90% of females consumed less than the 1980 recommended dietary allowance (RDA) of vitamin B-6. Sixty-four percent of all survey respondents reported a ratio of vitamin B-6 to dietary protein of less than 0.02 (expressed as mg/g protein). Foods from animal and plant sources provided 48% and 52% of the total vitamin B-6, respectively. Vitamin B-6 intake decreased (P less than 0.0001) with increasing age and decreasing education and income status. Beef steaks and roasts, alcoholic beverages, potatoes, ready-to-eat cereals, and milk were important dietary sources of vitamin B-6.     

Association between circulating white blood cell count and long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study

Inflammatory processes are implicated in the development and progression of age-related macular degeneration (AMD). However, there are limited data on longitudinal associations between systemic markers of inflammation and AMD. The authors examined the prospective relation between the circulating white blood cell (WBC) count and early and late AMD in a population-based cohort of 3,654 participants, aged 49-97 years, in the Blue Mountains region, Australia. The main outcome of interest was the 10-year incidence of early and late AMD among individuals free from corresponding disease at the baseline (1992-1994). An elevated baseline WBC count was associated with early AMD incidence, independent of smoking and other major confounders. The multivariable relative risk comparing tertile 3 of WBC count (>6.7 x 10(9) cells/liter) with tertile 1 (相似文献   

Associations between smoking and body weight in the US population: analysis of NHANES II.

Recent recommendations for increases in desirable body weights are based upon studies which did not consider the potential confounding effect of cigarette consumption on body weight. We investigated the relation between tobacco use and several anthropometric measurements in 12,103 men and women 19-74 years of age in the United States examined between 1976 and 1980 during the Second National Health and Nutrition Examination Survey (NHANES II). Cigarette smokers weighed less (mean +/- standard error = 69.8 +/- 0.2 kg) and were leaner (body mass index (weight (kg)/height (m)2) = 24.6 +/- 0.1) than nonsmokers (72.5 +/- 0.2 kg and 25.7 +/- 0.1, respectively), controlling for age and sex. Body leanness increased with the duration (but not intensity) of smoking. Ex-smokers were not heavier or fatter than nonsmokers, and these groups experienced similar weight gain after age 25 (approximately 6 kg in men, 9 kg in women), while current smokers gained substantially less weight (3.5 kg in men, 5.4 kg in women). Compared to nonsmokers, former and current smokers were also slightly taller. Most of these associations were evident in both sexes and all ages evaluated, and were not explained by differences in caloric intake, physical activity, illness, or socioeconomic status. Our findings suggest that the increased mortality observed among lean individuals in previous studies may have been due to smoking rather than leanness per se, and that as a result, currently accepted desirable body weights may be overestimated.     

急性百草枯中毒早期白细胞计数与预后的相关性探讨

将本院中毒科2008年1月—2014年12月间收治的183例急性百草枯中毒患者按就诊后首次外周血白细胞计数分为A组(≤10×10~9/L)、B组(10×10~9/L~20×10~9/L)、C组(20×10~9/L~30×10~9/L)、D组(30×10~9/L)四组,按照中毒结局(存活和死亡)对各组的存活率进行比较分析。结果显示,183例急性百草枯中毒患者经治疗后,各组存活率分别为78.72%、44.32%、5.00%和0。四组间不同白细胞计数在中毒结局上存在明显差异,早期外周血白细胞计数可作为急性百草枯中毒预后的初步判断。     

Serum ferritin and death from all causes and cardiovascular disease: the NHANES II Mortality Study. National Health and Nutrition Examination Study

PURPOSE: The purpose of this study was to assess the association between serum ferritin and death from all causes, cardiovascular diseases (CVD), CHD and myocardial infarction (MI). Positive body iron stores have been proposed as a risk factor for coronary heart disease (CHD). While most epidemiologic studies using serum ferritin and other measures of body iron stores have not found an association between iron and heart disease risk, the hypothesis remains controversial. As a result, we examined the relationship of serum ferritin, the principle blood measure of body iron stores, to risk of death in a cohort with a standardized exam and long follow-up. METHODS: The baseline data for this prospective cohort study were collected in 1976-1980 as part of the second National Health and Nutrition Examination Study (NHANES II) with mortality follow-up using the National Death Index (NDI) through December 31, 1992. The analytic sample (n = 1604) consisted of 128 black men, 658 white men, 100 black women and 718 white women 45-74 years of age at baseline who, based on self-reported data, were free of coronary heart disease at baseline and had no missing data. The main outcome measures were the relative risk of death for persons with serum ferritin levels: <50 microg/L; or 100-199 microg/L; or > or =200 microg/L was compared to persons with serum ferritin levels of 50-99 microg/L adjusted for possible confounding using the Cox proportional hazards model. RESULTS: Most of the deaths were among white men (n = 254) and women (n = 168). There were relatively few deaths among black men (n = 50) and too few in women (n = 23) to reliably model. The largest number of CVD (n = 119), CHD (n = 82), and MI (n = 49) deaths were in white men while there were 69 CVD, 45 CHD and 13 MI deaths in white women. Black men with a serum ferritin level of <50 microg/L had a significantly higher adjusted risk of death from all causes (RR = 3.1 with 95% confidence limits of 1.5-6.5). There were no other statistically significant associations for all causes mortality for the other three race/sex groups. Additionally, there were no statistically significant associations between serum ferritin and any of the cardiovascular endpoints for any of the groups. There was an apparent but nonsignificant u-shaped association between serum ferritin and all causes mortality in black men and between serum ferritin and CVD death in white women. However, in both cases very wide confidence limits preclude further interpretation. CONCLUSIONS: Overall, the results do not support the hypothesis that positive body iron stores, as measured by serum ferritin, are associated with an increased risk of CVD, CHD or MI death or between serum ferritin and all causes mortality. Most of the research to date with serum ferritin has been conducted in European men or in European American men. Our results are consistent with the primarily negative results for that race/sex group. More research is needed in women and minority groups, including an explanation of why such an association would exist in these groups but not in white men before an association can be established in them.     

Trends in relative risk estimates for the association between air pollution and mortality in The Netherlands, 1992-2006

Background

Daily variations in the levels of air pollution are well known to be associated with daily variations in mortality counts. Given the large number of time-series studies, there is little need for simple replication of these results in additional locations. However, additional analyses of time-series data might be useful in elucidating remaining questions on the role of air pollution on mortality.

Objectives

Because of ongoing issues related to causality, changing toxicity, the difficulty in isolating the independent effects of individual pollutants, the availability of new methods to detect effect thresholds, and questions about the extent to which effects are restricted to frail members of the population, additional analyses of time-series data might be helpful in addressing these issues. We show an example where additional time-series analyses can be helpful in elucidating specific questions in the field of air pollution epidemiology.

Methods

We analysed daily mortality and air pollution data using Poisson regression in generalised additive models. Air pollution data for the overall period 1992–2006 and for four different periods were analysed to assess the overall risk estimates for the whole period and to assess variability over time for the different effect estimates.

Results and Conclusion

We found some statistically significant upward trends, but this was only the case for a few associations without a consistent pattern over the cause-specific deaths. Whether these findings are consistent over time or whether our findings are merely the result of statistical chance can only be elucidated by continuation of monitoring of the relative risks over time in the future. Although these results may indicate that both photochemical and particulate matter air pollution might have become more toxic, the lack of a clear pattern in the results makes these conclusions speculative.     

外周血白细胞与高脂血症的关联性：一项孟德尔随机化和观察性研究

目的 探究外周血白细胞及分类计数与血脂间的关联,旨在为高脂血症的防控提供依据。方法 回顾性分析2017—2020年于某医院进行健康体检者的资料。采用限制性立方样条模型拟合外周血白细胞及分类计数与血脂间的剂量-反应关系。基于全基因组关联研究(Genome-wide association study, GWAS)的汇总数据,运用两样本孟德尔随机化探究白细胞分类计数与血脂指标间的因果关联。采用白细胞分类计数相关的遗传位点作为工具变量,使用逆方差加权、MR-Egger回归和加权中位数法进行孟德尔随机化分析;采用异质性检验、多效性检验和逐个剔除检验进行敏感性分析。结果 共纳入18 647例体检者进行横断面分析,高脂血症患病率为42.70%,且患者的白细胞及分类计数均高于非高脂血症者(P<0.05)。白细胞及分类计数增加可导致高脂血症患病风险增加(P<0.05);且与总胆固醇、低密度脂蛋白胆固醇和甘油三酯升高有关(单核细胞、中性粒细胞和嗜酸性粒细胞除外),与高密度脂蛋白胆固醇降低有关(P<0.05)。遗传预测的淋巴细胞与低密度脂蛋白胆固醇(OR=1.04, 95%CI:1.01...     

Associations between air pollution and mortality in Phoenix, 1995-1997

We evaluated the association between mortality outcomes in elderly individuals and particulate matter (PM) of varying aerodynamic diameters (in micrometers) [PM(10), PM(2.5), and PM(CF )(PM(10) minus PM(2.5))], and selected particulate and gaseous phase pollutants in Phoenix, Arizona, using 3 years of daily data (1995-1997). Although source apportionment and epidemiologic methods have been previously combined to investigate the effects of air pollution on mortality, this is the first study to use detailed PM composition data in a time-series analysis of mortality. Phoenix is in the arid Southwest and has approximately 1 million residents (9. 7% of the residents are > 65 years of age). PM data were obtained from the U.S. Environmental Protection Agency (EPA) National Exposure Research Laboratory Platform in central Phoenix. We obtained gaseous pollutant data, specifically carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide data, from the EPA Aerometric Information Retrieval System Database. We used Poisson regression analysis to evaluate the associations between air pollution and nonaccidental mortality and cardiovascular mortality. Total mortality was significantly associated with CO and NO(2) (p < 0.05) and weakly associated with SO(2), PM(10), and PM(CF) (p < 0. 10). Cardiovascular mortality was significantly associated with CO, NO(2), SO(2), PM(2.5), PM(10), PM(CF) (p < 0.05), and elemental carbon. Factor analysis revealed that both combustion-related pollutants and secondary aerosols (sulfates) were associated with cardiovascular mortality.