title: White blood cell count is associated with carotid and femoral atherosclerosis.
abstract: OBJECTIVE
  Chronic low-grade inflammation is associated with atherosclerosis. Ultrasound imaging allows measurement of intima-media thickness (IMT) and plaque. We investigated the association between inflammatory markers and carotid and femoral atherosclerosis.
  
  
  METHODS
  We studied 554 subjects with primary dyslipidemia (57% men, median age 49 years) and 246 age- and sex-matched normolipidemic subjects. Carotid and femoral arteries were imaged bilaterally with a standardized protocol. Mean and maximum common carotid IMT (CC-IMT and MaxCC-IMT) and common femoral IMT (F-IMT and MaxF-IMT), and carotid and femoral plaque were assessed. Carotid atherosclerosis was defined by CC-IMT and/or plaque height >75th percentile of a reference population. White blood cell count (WBCC) was measured in all subjects. High-sensitivity C-reactive protein (CRP) was measured in 330 dyslipidemic subjects.
  
  
  RESULTS
  The age- and sex-adjusted probability of carotid atherosclerosis and femoral plaque increased by 20% (odds ratio [OR] 1.20; 95% CI, 1.10-1.31) and 25% (1.25; 1.13-1.38), respectively, for each 1000/mm(3) WBCC increment. WBCC was associated with age- and sex-adjusted CC-IMT and MaxCC-IMT (p<0.05, both), and F-IMT and MaxF-IMT (p<0.001, both). Adjustment for cardiovascular risk factors did not influence these associations. CRP was associated with CC-IMT and MaxCC-IMT (p<0.05, both), but the associations disappeared after adjustment for body mass index. CRP was unrelated to carotid plaque or measures of femoral atherosclerosis.
  
  
  CONCLUSIONS
  WBCC, but not CRP, related to early and advanced measures of atherosclerosis independently of risk factors. Our findings support using the heretofore undervalued WBCC as an easy-to-measure, low-cost diagnostic marker of atherosclerosis.
authors.affiliation: Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona, Spain. eortega1@clinic.ub.es
authors.forename: Emilio
authors.initials: E
authors.lastname: Ortega
authors.forename: Rosa
authors.initials: R
authors.lastname: Gilabert
authors.forename: Isabel
authors.initials: I
authors.lastname: Nuñez
authors.forename: Montserrat
authors.initials: M
authors.lastname: Cofán
authors.forename: Aleix
authors.initials: A
authors.lastname: Sala-Vila
authors.forename: Eric
authors.initials: E
authors.lastname: de Groot
authors.forename: Emili
authors.initials: E
authors.lastname: Ros
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000276:immunology; D002097:C-Reactive Protein / Q000032:analysis; D002340:Carotid Artery Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000276:immunology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007958:Leukocyte Count; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain
chemical_list: D018836:Inflammation Mediators; D002097:C-Reactive Protein