White cell counts in relation to mortality in a general population of cohort study in the Netherlands: a mediating effect or not?
Keywords: 
White cell count (WCC)
Body mass index
Smoking
Multivariate cox regression models
Issue Date: 
2019
Publisher: 
BMJ
ISSN: 
2044-6055
Note: 
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Citation: 
Abete, I. (Itziar); Lu, Y. (Yunxia); Lassale, C. (Camille); et al. "White cell counts in relation to mortality in a general population of cohort study in the Netherlands: a mediating effect or not?". BMJ Open. 9, 2019, e030949
Abstract
Background: White cell count (WCC) is a clinical marker of inflammation. Data are limited regarding the association of total and differential WCC with risk of mortality, and its role related with smoking and body mass index (BMI). Methods: A total of 14 433 participants (4150 men; 10 283 women; average age 47.3±11.8 years) from the Dutch European Prospective Investigation into Cancer and Nutrition-Netherlands cohort were included. The associations between prediagnostic total WCC and its subtypes and risk of all-cause, cancer and cardiovascular disease (CVD) mortality were assessed. The role of WCC related with smoking and BMI on mortality was further explored. Multivariate Cox regression models were performed to estimate the HR and 95% CI. Results: After an average follow-up of 15.8 years, a total of 936 death cases were identified (466 cancer; 179 CVD; 291 other causes). Statistically significant graded associations between total WCC, and counts of lymphocytes, monocytes, neutrophils and eosinophils and risk of total mortality were observed. These associations were more apparent in current smokers. Strong associations for all-cause mortality or cancer mortality were observed in subjects with BMI ≥25 kg/m2 , ever smoking and elevated WCC (HR 3.92, 95%CI 2.76 to 5.57; HR 3.93, 95%CI 2.30 to 6.72). WCC partly mediated the associations between smoking or BMI and all-cause mortality. Conclusions: Prediagnostic WCC and its subtypes are associated with all-cause, cancer and CVD mortality risk. It may play a partially mediate role on the association between smoking or obesity and mortality

Files in This Item:
Thumbnail
File
e030949.full.pdf
Description
Size
385.79 kB
Format
Adobe PDF


Items in Dadun are protected by copyright, with all rights reserved, unless otherwise indicated.