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White blood cell count in young adulthood and coronary artery calcification in early middle age: coronary artery risk development in young adults (CARDIA) study

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Abstract

White blood cell (WBC) count is associated with incident coronary heart disease (CHD). Data are sparse regarding its association in young adults with future coronary artery calcification (CAC). Our study was conducted among coronary artery risk development in young adults (CARDIA) participants (n = 3,094). We examined the association between baseline (Y0) WBC counts and CHD risk factors using linear regression models. We further assessed prospective associations between Y0 WBC and inflammatory biomarkers during the follow-up, and the presence of CAC 15 and 20 years later. In total, 272 and 566 subjects had CAC scores >0 at year (Y) 15 and Y20, respectively. Baseline total WBC counts were cross-sectionally associated with SBP, BMI, and smoking, or HDL-cholesterol (p ≤ 0.01) at Y0, and prospectively associated with C-reactive protein at Y7, Y15, and Y20, and fibrinogen at Y5 and Y20 (p < 0.01). After adjustment for potential confounding factors, baseline neutrophil count was borderline associated with CAC presence 15 years later (OR = 1.18 per unit, 95 % CI 1.00–1.44) and total WBC (OR = 1.07, 95 % CI 0.96–1.19) or eosinophil (OR = 1.12, 95 %CI 1.00–1.25) was borderline associated with CAC presence at Y20. Baseline total WBC counts in young adults was associated prospectively with CAC presence 20 years later after adjusting for age, sex, and race. Results are attenuated when other risk factors are accounted for. Our results suggest the possible early involvement of WBC, particularly eosinophils, in the early stages of atherosclerosis.

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Acknowledgments

The Coronary artery risk development in young adults study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (N01-HC95095 & N01-HC48047), University of Minnesota (N01-HC48048), Northwestern University (N01-HC48049), and Kaiser Foundation Research Institute (N01-HC48050). This manuscript has been reviewed by CARDIA for scientific content and consistency of data interpretation with previous CARDIA publications.

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Authors and Affiliations

  1. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Dr. suite 1400, Chicago, IL, 60611, USA

    Lifang Hou, Donald M. Lloyd-Jones, Hongyan Ning, Mark D. Huffman, Xiao Zhang & Kiang Liu

  2. Institute of Molecular Medicine, University of Texas Health Sciences Center, 1825 Pressler Street, Houston, TX, 77030, USA

    Myriam Fornage

  3. Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, 2200 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA

    Ka He

  4. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. Second Street, Suite 300, Minneapolis, MN, 55454, USA

    David R. Jacobs

  5. Public Health Sciences and Internal Medicine, Wake Forest University Health Sciences, 2000 West First Street, Second Floor, Winston-Salem, NC, 27104, USA

    David C. Goff

  6. Kaiser Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA

    Steve Sidney

  7. Division of Radiological Sciences, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC, 27103, USA

    Jeffrey J. Carr

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  1. Lifang Hou
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Correspondence to Xiao Zhang.

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Hou, L., Lloyd-Jones, D.M., Ning, H. et al. White blood cell count in young adulthood and coronary artery calcification in early middle age: coronary artery risk development in young adults (CARDIA) study. Eur J Epidemiol 28, 735–742 (2013). https://doi.org/10.1007/s10654-013-9842-7

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