周邊血液中各種白血球分類數目與後續轂死夭率、癌症死夭率及心臟血管疾病死夭率間之相 關性

BACKGROUND AND PURPOSE: A higher total leukocyte count has been reported to predict all-cause mortality in men, but data are limited for this relation in women and for the relation between differential leukocyte counts and all-cause mortality in both men and women. This study was designed to analyze these relationships in Taiwanese. METHODS: A total of 8447 subjects were enrolled from participants in a physical check-up program at National Taiwan University Hospital from 1995 to 1997. Information on mortality was obtained from a national mortality databank that was updated to the end of 2001. Data were analyzed by Student's t test and Cox regression analysis. RESULTS: Among the 245 deaths, 88 were due to cancer and 62 were due to cardiovascular diseases. Cox regression analysis revealed an inverse association between lymphocyte count and all- cause mortality in the study group as a whole (all subjects, p < 0.01, hazard ratio = 0.73). This inverse association was mainly due to an inverse association between lymphocyte count and cancer mortality (p < 0. 05, hazard ratio = 0.64), especially the mortality from hepatoma (p = 0. 010, hazard ratio = 0.29 ). The latter hazard ratio of 0.29 indicates that , in all subjects, every decrease of 1.0 x 10(9)/L in lymphocyte count increased the risk of mortality from hepatoma by 3.45- fold during an average follow-up period of 65.5 months. There was a positive association between total leukocyte count and all-cause mortality in men (p < 0.05, hazard ratio = 1.10), mainly due to both the neutrophil and monocyte counts having positive associations with the cardiovascular mortality ( both p < 0.05, hazard ratio = 1.23 and 1.22, respectively). The latter hazard ratio of 1.22 indicates that, in men, every increase of 0.1 x 10(9) /L in monocyte count increased the risk of cardiovascular mortality by 1. 22 -fold. CONCLUSIONS: In Taiwanese adults of both genders, a lower lymphocyte count is associated with cancer mortality, especially mortality from hepatoma. In Taiwanese men, higher neutrophil and monocyte counts are associated with cardiovascular mortality

Peripheral Differential Leukocyte Counts in Humans Vary with Hyperlipidemia, Smoking, and Body Mass Index

The human reports of diverse relationships between different serum lipid levels and peripheral total leukocyte count and a unique lower peripheral monocyte count in hypercholesterolemia have driven us to think that, in human beings, peripheral differential leukocyte counts may be influenced differently by different types of hyperlipidemia and may have different relationships with various serum lipid levels. This is the main reason and purpose of this study. Our subjects were selected from Taipei residents who attended a regular health check program in our hospital in 1998. A total of 3282 subjects were enrolled, including 1677 normolipidemic, 960 untreated borderline hyperlipidemic, and 645 untreated hyperlipidemic subjects. By one-way ANOVA, we found that different types of hyperlipidemia were associated with significant differences in differential leukocyte counts. In hypertriglyceridemia, the total leukocyte count and counts of all leukocyte subtypes were significantly higher than those in normolipidemia

Correlation between Serum Lipid Profiles and the Ratio and Count of the Cd16+Monocyte Subset in Peripheral Blood of Apparently Healthy Adults

Background and Purpose: Deposited vascular oxidized low- density lipoproteins (LDLs) are important triggers of the transformation of circulatory monocytes into macrophages. CD 16+ monocytes have been reported to be the precursors of tissue macrophages, In this study, we sought to determine the relationship between serum LDL-cholesterol and the percentage and count of the CD16+ monocyte subset in the peripheral blood of healthy adults. Methods: We studied the correlations between serum lipid profiles and both peripheral CD16+ and CD36+ monocyte subset ratios and counts in apparently healthy adults (50 men and 50 women). Monocyte surface antigens CD16 and CD36 on CD14+ monocytes were detected using fluorescent triple staining and flow- cytometry. Surface staining was performed by incubating 1 x 10(6) blood mononuclear cells with phycoerythrin-conjugated anti-CD14, fluorescein isothiocyanate-conjugated anti-CD36, and respective control isotopes (mouse IgGs). A total of 5, 000 cells were counted and the frequency of surface antigens was determined by FACscan. Results: A significant positive link between LDL-cholesterol and the CD16+ subset ratio was found by linear correlation analysis (p < 0 .05) but not by multivariate regression analysis. Both linear correlation analysis and ANOVA, revealed a significant inverse link between high- density lipoprotein (HDL)-cholesterol and the CD16+ subset ratio (both p<0 .01). By multivariate regression analysis, gender was the main 0 significant determinant for the CD16+ subset ratio. When serum total cholesterol (TC) was excluded from the analysis to avoid the interference from collinearity between serum TC and LDL (r = 0.84), HDL- cholesterol became independently and inversely linked to the CD16+ subset ratio. There were independent inverse links between HDL-cholesterol and the counts of all monocytes, CD 16+, monocytes, and CD36+ monocytes. Conclusions: Our results suggest that circulating HDL-cholesterol may be much more important than LDL-cholesterol in affecting the transformation of circulatory monocytes into macrophages. The inverse link between HDL- cholesterol and the number of macrophage precursors in peripheral blood might contribute partly to the well-known antiatherogenic effect of HDL- cholesterol

Revision in Reference Ranges of Peripheral Total Leukocyte Count and Differential Leukocyte Percentages Based on a Normal Serum C-Reactive Protein Level

A higher total leukocyte count is a predictor of all-cause mortality and cardiovascular morbidity. The currently used reference range for peripheral total leukocyte count is wide (4.5–11.0 × 109/L) and is associated with a low sensitivity in identifying non-infectious chronic diseases. We attempt to revise it based on a normal serum C-reactive protein (CRP) level. Methods: Study subjects were participants in a health check program at our hospital between 2000 and 2002. Those whose leukocyte analysis had been checked with the Sysmex Cell Counter NE-9000 were enrolled. Results: Significantly positive relationships between CRP level and total leukocyte count, neutrophil percentage, and monocyte percentage were found in all subjects (n = 14,114; p< 0.0001). In contrast, CRP level had a significantly inverse correlation with lymphocyte percentage (p < 0.0001). A proposed new reference range for total leukocyte count was estimated based on the data in the normal CRP level group (CRP < 0.1 mg/dL; n = 4839). To rest on the essence of statistics that the range of [mean ± 2 standard deviations] contains approximately the middle 95% of observations in a sampled population, a new reference range for total leukocyte count was accordingly estimated to be 3.11–8.83 × 109/L. Conclusion: In view of the abundant evidence showing that a higher peripheral total leukocyte count is harmful to health, a down-correction of its upper reference range from the currently used 11.0 × 109/L to the proposed 8.83 × 109/L, based on a normal CRP level, should allow more abnormal health conditions to be identified and promote the usefulness of peripheral leukocyte analysis