Lymphocyte count was significantly associated with hyper-LDL cholesterolemia independently of high-sensitivity C-reactive protein in apparently healthy Japanese

Applying spectrochemical analyses on venous disease patients treated by N-Butyl Cyanoacrylate Ablation Surgery

BACKGROUND: The venous disease of the legs is a common disease among adults that may lead to a deterioration in the structure and concentration of biomolecules. N-Butyl Cyanoacrylate Ablation Surgery (NBCA) or cyanoacrylate embolization (CAE) technique to adhesive the saphenous vein is an alternative method for the treatment of venous disease. OBJECTIVE: We aimed to show what kind of changes occurs after CAE surgery using FTIR spectroscopy combined chemometrics. We compared before and after surgery blood sera of patients to find whether a correlation between spectral data and laboratory indexes. We studied the blood sera of those who suffered from varicose veins and treated them by CAE technique. METHODS: In order to examine the molecular profiles in blood sera who underwent the CAE technique of the great saphenous vein for the treatment we used Fourier Transform InfraRed spectroscopy (FTIR) spectroscopy of blood samples of patients before and after surgery as a fast diagnostic technique. To obtain information about the spectra variation among the types of samples Principal component analysis (PCA) was performed for fingerprint, amide II with amide I regions. To find normality among variations Partial Least Square P-P plot of residual was performed. RESULTS: Absorbance values were statistically significant only in amide II, amide I, and OH vibrations. In the blood collected before surgery, higher peaks area of α-helix and β-harmonica were noticed. However, in both groups of samples, a higher amount of β-harmonica was visible. Pearson correlation analysis showed that the value of white blood cells (WBC) correlate with absorbance at 2858 cm-1 wavenumber. Moreover, a correlation between neutrophil (NEU) and OH vibrations, and between hematocrit (HCT) and 1082 cm-1, were found. Furthermore, a high correlation Platelets (PLT) and FTIR peak at 1165 cm-1, was noticed. CONCLUSIONS: This methodology suggests with PCA analysis CAE caused structural and quantitative chemical changes in blood samples of patients.

Association between greenness and dyslipidemia in patients with coronary heart disease: A proteomic approach

BACKGROUND

Residential surrounding greenness may be protective of dyslipidemia are often theorized but remain poorly quantified. In particular, the underlying biological mechanisms of blood lipid changes with green spaces remain unclear.

METHODS

Our observational epidemiology study included a residentially stable sample of 1035 coronary heart disease patients, and proteomics study included 16 participants. Normalized Difference Vegetation Index (NDVI) was used to evaluate residential greenness exposures. Proteomics technology was used to identify plasma greenness-related proteome disturbance, and the pathway analysis was employed to evaluate the potential biological mechanisms of greenness decreasing dyslipidemia risk.

RESULT

Higher residential surrounding greenness in the 500-m area was associated with lower risks of dyslipidemia (odds ratio (OR) = 0.871, 95% confidence interval (CI): 0.763, 0.994 for per one-quartile NDVI increase). Lymphocytes mediated 18.7% of the association between greenness and dyslipidemia. Greenness related proteins (including PLXDC1, IGFBP2 and LY6D) may regulate the biological functions of lipid metabolism and transport-related proteins (including ADIPOQ and CES1) through a series of biological processes.

CONCLUSION

People in greener surroundings have a lower risk of dyslipidemia, which may be due to their lower inflammation, stronger lipid transporter activity, and normal cholesterol metabolism.

Hematological Inflammatory Markers in Patients with Clinically Confirmed Familial Hypercholesterolemia

Background and Aims. Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder of lipid metabolism which leads to premature cardiovascular diseases. In patients with FH, blood inflammatory markers may be disrupted; however, its extent is unclear. In this study, we aimed to evaluate the NLR (neutrophil to lymphocyte ratio), PLR (platelet count to lymphocyte count ratio), MPV (mean platelet volume), RPR (red blood cell distribution width to platelet count ratio), WBC (white blood cell), and PDW (platelet distribution width and platelet count). Methods. The patients were selected from laboratories due to high cholesterol level and who had history of premature cardiovascular disease. The Dutch Lipid Clinic Network (DLCN) criteria are used for the detection of FH. Controls had a history of hyperlipidemia, and both groups could be on pharmacotherapy or not. All the biochemical markers were evaluated using appreciate methods. Statistical analysis was done using STATA 14. Results. The study group consisted of 1074 patients with FH and 473 control cases. Of the CBC inflammatory markers, only PLR was significantly ( $p\text{value}=0.003$ ) higher in FH patients ( $7.96\pm 10.08$ ) compared to non-FH ( $6.45\pm 2.44$ ). In FH patients, the PLR was significantly higher in probable/definite FH group ( $9.70\pm 14.06$ ) compared to possible FH ( $7.36\pm 8.23$ ) ( $p\text{value}<0.001$ ). Linear regression analysis showed that only RLR was independently associated with total cholesterol ( $b=0.000$ , $p=0.13$ ). Conclusions. Our results may show the importance of high cholesterol on platelet activity and highlight the use of lipid lowering drugs in patients with hyperlipidemia.

The association between lipid levels and leukocyte count: A cross-sectional and longitudinal analysis of three large cohorts

Background

Relationships between dyslipidaemia and leukocyte counts have been investigated in several studies, demonstrating limited evidence of associations in humans. As such, studying a diverse range of cohorts will ensure evidence is robust. This study focused on investigating cross-sectional and longitudinal relationships in three large-scale cohorts.

Methods

The cross-sectional analysis included a total of 27,566 participants with valid data on lipid measures and leukocyte counts from three study cohorts: National Health and Nutrition Survey (NHANES), Korean National Health and Nutrition Survey (KNHANES) and Treating to New Targets (TNT) trial. The longitudinal analysis included 9323 participants with valid data on lipid measures and leukocyte counts at baseline and one year with statin treatment. Associations between lipid levels and leukocyte counts were analysed by multivariable linear regression and adjusted for basic demographic and cardiovascular risk factors.

Results

Cross-sectional data from NHANES demonstrated the association of lower high-density lipoprotein (HDL) cholesterol and higher triglycerides with higher leukocyte count (0.9% lower and 0.3% higher count per 10 mg/dL increase in HDL cholesterol and triglycerides respectively, both p < 0.001). Similar trends were found in TNT trial (both p < 0.001), but not in KNHANES. In the TNT trial, 10 mg/dL increase in triglycerides over one year was also associated with a 0.09 × 103/μL increase in leukocyte count over the same period.

Conclusions

The findings of this study are consistent with those of previous human studies, supporting weak yet noteworthy associations between dyslipidaemia and leukocytosis.

Peripheral leukocyte counts vary with lipid levels, age and sex in subjects from the healthy population

BACKGROUND AND AIMS

Disorders in blood lipid metabolism and leukocyte-mediated inflammation are considered the main mechanisms of the pathogenesis of atherosclerosis. This study aims to show whether and how peripheral leukocyte counts are associated with serum lipid levels.

METHODS

This is a cross-sectional study of 175,079 subjects from the healthy population.

RESULTS

Age and sex are two key factors dictating the relationship between peripheral leukocyte counts and serum lipid levels. The log-transformed level of triglycerides (LnTG) was positively associated with all leukocyte counts in males except monocyte count in younger subjects. LnTG was positively associated with total leukocyte count in females regardless of age, and it was positively associated with lymphocyte and monocyte counts and neutrophil count only in elderly and young women, respectively. Total cholesterol levels were positively associated with total leukocyte, neutrophil and lymphocyte counts only in young males and with lymphocyte counts only in elderly women. LDL-C was negatively associated with monocyte count in males regardless of age; by contrast, it was positively associated with total leukocyte and lymphocyte counts in females regardless of age range and neutrophil and LnEosinophil counts only in young women. HDL-C was negatively associated with total leukocyte, lymphocyte and monocyte counts in both young men and young women; was negatively associated with monocyte count in elderly men and women; and was negatively associated with LnEosinophil count only in older men.

CONCLUSIONS

Peripheral leukocyte counts are extensively associated with serum lipid levels, with patterns differing by sex, age, lipid and leukocyte subset.

Gender Dictates the Relationship between Serum Lipids and Leukocyte Counts in the National Health and Nutrition Examination Survey 1999⁻2004

Dyslipidemias and leukocytosis are associated with cardiovascular disease and immune disorders. Mechanistic studies have shown lipoprotein metabolism to play a significant role in the regulation of atherosclerosis development and leukocyte activation, whereas lipid-lowering treatments have been shown to exert beneficial anti-inflammatory and immunomodulatory effects in clinical trials. However, the relationship between clinical markers of lipid metabolism and leukocyte counts has not been extensively evaluated at the population level. We aimed to determine whether clinical blood lipid measures are associated with leukocyte counts in the general U.S. population represented in the National Health and Nutrition Examination Survey (NHANES) 1999–2004, and whether differences exist between men and women (n = 5647). We observed a strong positive linear trend between serum triglycerides vs. blood lymphocyte and basophil counts in both men and women, whereas a positive trend between monocytes vs. triglycerides and lymphocytes vs. total cholesterol and LDL-cholesterol (LDL-C) was only detected in women. Conversely, HDL-C was inversely associated with a greater number of leukocyte subsets in men, whereas inverse trends between HDL-C vs. lymphocytes were observed in both men and women. In multiple regression models, a 10% increase in total cholesterol, LDL-C, and triglycerides was associated with a predicted 1.6%, 0.6%, and 1.4% increase in blood lymphocyte counts in women, respectively, whereas no relationship was observed in men. In both men and women, a 10% increase in triglycerides was additionally associated with higher lymphocyte, neutrophil, and basophil counts, whereas 10% increases in HDL-cholesterol were associated with significantly lower lymphocyte, neutrophil, eosinophil, and basophil counts in men, in addition to lower lymphocyte and monocyte counts in women. These findings suggest that clinical lipid markers may be used to predict blood leukocyte distributions, and that a gender-specific relationship exists between distinct classes of serum lipids and immune cell subsets.

Associations between CT-determined visceral fat burden, hepatic steatosis, circulating white blood cell counts and neutrophil-to-lymphocyte ratio

Visceral adiposity is associated with cardiovascular disease, an association that may be mediated in part by inflammation. We hypothesized that regional measures of visceral adiposity would associate with commonly obtained clinical measures of immune status. We consecutively studied 3,291 subjects (mean age, 49.8±9.8 years) who underwent an annual cardiovascular risk survey. Peri-cardial (PCF) and thoracic peri-aortic adipose tissue (TAT) volumes were determined by dedicated computed tomography (CT) software (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Hepatic steatosis was assessed by abdominal ultrasonography. We explored cross-sectional associations between visceral fat measures and high-sensitivity C-reactive protein (hs-CRP), leukocyte counts, and the neutrophil-to-lymphocyte ration (NLR). Among 3,291 study participants, we observed positive linear associations between PCF and TAT, higher degree of hepatic steatosis and hs-CRP, various leukocyte counts, either total and its differential counts, and NLR (all trend p<0.001). Multi-variate linear and logistic regression models showed independent associations between PCF/TAT (ß-Coef: 0.14/0.16, both p<0.05) and total WBC counts, with only TAT further demonstrated significant relations with neutrophil counts and NLR (both p<0.05) and independently identified abnormally high WBC and NLR (Odds ratio: 1.18 & 1.21, both p<0.05). C-statistics showed significant incremental model prediction for abnormally high WBC and NLR (both ΔAUROC<0.05) when TAT was superimposed on traditional cardiovascular risks and biochemical information. Greater visceral adiposity burden and hepatic steatosis may be associated with higher circulating leukocyte counts and markers for atherosclerosis, with more pronounced influences for peri-aortic adiposity. Our data suggested the differential biological impacts for region-specific visceral adiposity.

Blunted Autonomic Responses and Low-Grade Inflammation in Mongolian Adults Born at Low Birth Weight

Low birth weight (LBW) has been considered as a risk factor for adult hypertension that is associated with deterioration of autonomic functions and low-grade inflammation. To explore the above effects of LBW, we measured blood pressure (BP) and heart rate variability during postural change from a supine position to a sitting position in 21 healthy Mongolian adults aged 23-34 years: 4 with LBW (birth weight < 2,500 g), 13 with normal birth weight (NBW, 2,500 g ≤ birth weight < 4,000 g), and 4 with high birth weight (HBW, ≥ 4,000 g). Mongolian population is known to have higher prevalence of hypertension. The ratio of low frequency (LF, 0.04-0.15 Hz) to high frequency components (HF, 0.15-0.40 Hz) was used as an index of sympathetic nerve activity, and HF was used as an index of parasympathetic nerve activity. In contrast to the NBW group, the LBW and HBW groups showed no significant increase in heart rate, systolic BP and LF/HF following postural change. We also measured blood cell counts and other blood parameters related to inflammation. After adjusting for age, BMI, sex and family history of hypertension, LBW was retained as an independent predictor only for higher counts of leukocytes (β = -0.51, p < 0.05), basophils (β = -0.62, p < 0.01), eosinophils (β = -0.83, p < 0.001), and platelets (β = -0.61, p < 0.05). We propose that LBW leads to blunted autonomic responses and low-grade inflammation in seemingly healthy Mongolian adults.

Association of peripheral differential leukocyte counts with dyslipidemia risk in Chinese patients with hypertension: insight from the China Stroke Primary Prevention Trial

The aim of the present study was to examine the association between peripheral differential leukocyte counts and dyslipidemia in a Chinese hypertensive population. A total of 10,866 patients with hypertension were enrolled for a comprehensive assessment of cardiovascular risk factors using data from the China Stroke Primary Prevention Trial. Plasma lipid levels and total leukocyte, neutrophil, and lymphocyte counts were determined according to standard methods. Peripheral differential leukocyte counts were consistently and positively associated with serum total cholesterol (TC), LDL cholesterol (LDL-C), and TG levels (all P < 0.001 for trend), while inversely associated with HDL cholesterol levels (P < 0.05 for trend). In subsequent analyses where serum lipids were dichotomized (dyslipidemia/normolipidemia), we found that patients in the highest quartile of total leukocyte count (≥7.6 × 10⁹ cells/l) had 1.64 times the risk of high TG [95% confidence interval (CI): 1.46, 1.85], 1.34 times the risk of high TC (95% CI: 1.20, 1.50), and 1.24 times the risk of high LDL-C (95% CI: 1.12, 1.39) compared with their counterparts in the lowest quartile of total leukocyte count. Similar patterns were also observed with neutrophils and lymphocytes. In summary, these findings indicate that elevated differential leukocyte counts are directly associated with serum lipid levels and increased odds of dyslipidemia.

Platelet-to-Lymphocyte Ratio Predicts Contrast-Induced Nephropathy in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

We assessed the relation between platelet-to-lymphocyte ratio (PLR) on admission and contrast-induced nephropathy (CIN) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). A total of 488 patients with NSTE-ACS who underwent urgent coronary angiography were enrolled. Levels of PLR and creatinine were measured before angiography and at 72 hours after angiography. Patients were divided into 2 groups, namely, the CIN group, 80 patients (16.3%; age 65.3 ± 12.5years; 66.7% men) and the non-CIN group, 408 patients (83.7%; age 61.2 ± 12.3 years; 72.5% men). Patients in the CIN group had significantly higher PLR than those in the non-CIN group (152.9 ± 99.6 vs 120.4 ± 66.1, P < .001). In logistic regression analysis, PLR (odds ratio [OR] 1.004, 95% confidence interval [CI] 1.001-1.007, P = .02), diabetes mellitus (OR 1.75, 95% CI 1.02-2.98, P = .03), and ST-segment depression on admission electrocardiogram (OR 1.68, 95% CI 1.00-2.81, P = .04) were independent predictors of CIN. The PLR was an independent predictor of CIN after angiography in patients with NSTE-ACS.

Association of obesity with leukocyte count in obese individuals without metabolic syndrome

AIMS

Inflammation in obesity is associated to insulin resistance (IR), hyperglycemia, hypertension and hyperlipidemia. Leukocytes play an important role in obesity associated inflammation. The initial factors that generate the inflammatory events in the obesity remain unclear. Therefore, the aim of this study was to determine the association of circulating leukocytes with clinical and biochemical parameters in obese individuals with clinical and biochemical parameters in normal range and with or without IR.

METHODS

Nineteen obese non-diabetic and 9 lean subjects were studied for serum levels of insulin, lipids, glycated hemoglobin, glycemia, for clinical parameters as HOMA-IR, arterial pressure and anthropometric parameters, and for leukocyte counts. Neutrophil/lymphocyte ratio (N/L) was calculated using the loge of leukocyte counts. Association between leukocytes and studied parameters was determined by Pearson's correlation.

RESULTS

Two groups of obese individuals were observed: with high levels of insulin (with IR) and with normal levels (without IR). Positive correlations were observed between leukocyte and lymphocyte counts with body mass index and HOMA-IR and negative correlation with decreased HDL levels. Lymphocytes correlated with increased levels of insulin. Leukocytes and neutrophils correlated positively with increased visceral fat and liver steatosis. These associations were absent in the obese group without IR. N/L ratio did not show correlations with studied parameters. The leukocyte associations were mainly observed in obese individuals with IR.

CONCLUSIONS

These data may represent initial leukocyte associations with morbidity features and define two different obese individuals that may evolve to the chronic inflammation observed in the obesity.

Cholesterol selectively regulates IL-5 induced mitogen activated protein kinase signaling in human eosinophils

Eosinophils function contributes to human allergic and autoimmune diseases, many of which currently lack curative treatment. Development of more effective treatments for eosinophil-related diseases requires expanded understanding of eosinophil signaling and biology. Cell signaling requires integration of extracellular signals with intracellular responses, and is organized in part by cholesterol rich membrane microdomains (CRMMs), commonly referred to as lipid rafts. Formation of these organizational membrane domains is in turn dependent upon the amount of available cholesterol, which can fluctuate widely with a variety of disease states. We tested the hypothesis that manipulating membrane cholesterol content in primary human peripheral blood eosinophils (PBEos) would selectively alter signaling pathways that depend upon membrane-anchored signaling proteins localized within CRMMs (e.g., mitogen activated protein kinase [MAPK] pathway), while not affecting pathways that signal through soluble proteins, like the Janus Kinase/Signal Transducer and Activator of Transcription [JAK/STAT] pathway. Cholesterol levels were increased or decreased utilizing cholesterol-chelating methyl-β-cyclodextrin (MβCD), which can either extract membrane cholesterol or add exogenous membrane cholesterol depending on whether MβCD is preloaded with cholesterol. Human PBEos were pretreated with MβCD (cholesterol removal) or MβCD+Cholesterol (MβCD+Chol; cholesterol delivery); subsequent IL-5-stimulated signaling and physiological endpoints were assessed. MβCD reduced membrane cholesterol in PBEos, and attenuated an IL-5-stimulated p38 and extracellular-regulated kinase 1/2 phosphorylation (p-p38, p-ERK1/2), and an IL-5-dependent increase in interleukin-1β (IL-1β) mRNA levels. In contrast, MβCD+Chol treatment elevated PBEos membrane cholesterol levels and basal p-p38, but did not alter IL-5-stimulated phosphorylation of ERK1/2, STAT5, or STAT3. Furthermore, MβCD+Chol pretreatment attenuated an IL-5-induced increase in cell survival at 48 hours, measured as total cellular metabolism. The reduction in cell survival following cholesterol addition despite unaltered STAT phosphorylation contradicts the current dogma in which JAK/STAT activation is sufficient to promote eosinophil survival, and suggests an additional, unidentified mechanism critically regulates IL-5-mediated human PBEos survival.

Longitudinal associations between lymphocyte count and LDL cholesterol in a health screening population

BACKGROUND

Longitudinal associations between leukocyte subtype counts and LDL cholesterol have not been reported.

METHODS AND RESULTS

This is a retrospective observational study in a health screening population. Spearman's correlation coefficients were calculated between leukocyte subtype counts and LDL cholesterol levels at baseline and after four years. Using Cox regression models, hazard ratios (HRs) of hyper-LDL cholesterolemia for leukocyte subtype counts during four years of follow-up were calculated adjusted for age, sex, high-sensitivity C-reactive protein (hs-CRP) and other confounders. Spearman's correlation coefficients (p values) between changes in counts of neutrophil, lymphocyte, monocyte, basophil and eosinophil and changes in LDL cholesterol levels through 4 years were 0.02 (0.494), 0.12 (<0.001), 0.06 (0.016), 0.02 (0.524) and 0.03 (0.257), respectively among 1735 subjects who visited our medical check-up center, did not use anti-hyperlipidemic drugs and revisited after 4 years. Among 1992 followed subjects, 481 developed hyper-LDL cholesterolemia during four years (60.4 per 1000 person-years). The HRs (95% confidence intervals; p values) of hyper-LDL cholesterolemia for each one SD increase in counts of neutrophil, lymphocyte, monocyte, basophil and eosinophil were 1.08 (0.99-1.19; 0.085), 1.14 (1.04-1.25; 0.005), 1.05 (0.95-1.15; 0.339), 1.01 (0.92-1.11; 0.858) and 1.04 (0.95-1.14; 0.397), respectively.

CONCLUSIONS

Lymphocyte count and LDL cholesterol were longitudinally positively correlated and lymphocyte count was associated with incidence of hyper-LDL cholesterolemia independently of hs-CRP in a health screening population.

Neutrophil-to-lymphocyte ratio predicts contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention

We investigated the relationship between baseline neutrophil-to-lymphocyte ratio (NLR) and contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI). Consecutive patients diagnosed with STEMI (n = 691) who underwent primary percutaneous coronary intervention (p-PCI) were included in the study. The CIN was defined as an increase in serum creatinine concentration ≥25% over baseline at 48 hours. Both NLR and C-reactive protein levels were significantly higher in the CIN group. There was a stronger correlation in patients with a known history of chronic kidney disease and in patients with a history of diabetes mellitus (DM). Advanced age, DM, low baseline glomerular filtration rate, reduced postprocedural ST resolution, high amount of contrast media, high NLR, and low left ventricular ejection fraction were independent predictors of CIN. The NLR may be used as a simple and reliable indicator of CIN in patients with STEMI who underwent p-PCI.

White blood cell counts as risk markers of developing metabolic syndrome and its components in the PREDIMED study

Background

The Metabolic Syndrome (MetS) is a cluster of metabolic abnormalities that includes hyperglucemia, hypertension, dyslipidemia and central obesity, conferring an increased risk of cardiovascular disease. The white blood cell (WBC) count has been proposed as a marker for predicting cardiovascular risk. However, few prospective studies have evaluated the relationship between WBC subtypes and risk of MetS.

Methods

Participants were recruited from seven PREDIMED study centers. Both a baseline cross-sectional (n = 4,377) and a prospective assessment (n = 1,637) were performed. Participants with MetS at baseline were excluded from the longitudinal analysis. The median follow-up was 3.9 years. Anthropometric measurements, blood pressure, fasting glucose, lipid profile and WBC counts were assessed at baseline and yearly during the follow-up. Participants were categorized by baseline WBC and its subtype count quartiles. Adjusted logistic regression models were fitted to assess the risk of MetS and its components.

Results

Of the 4,377 participants, 62.6% had MetS at baseline. Compared to the participants in the lowest baseline sex-adjusted quartile of WBC counts, those in the upper quartile showed an increased risk of having MetS (OR, 2.47; 95%CI, 2.03–2.99; P-trend<0.001). This association was also observed for all WBC subtypes, except for basophils. Compared to participants in the lowest quartile, those in the top quartile of leukocyte, neutrophil and lymphocyte count had an increased risk of MetS incidence. Leukocyte and neutrophil count were found to be strongly associated with the MetS components hypertriglyceridemia and low HDL-cholesterol. Likewise, lymphocyte counts were found to be associated with the incidence of the MetS components low HDL-cholesterol and high fasting glucose. An increase in the total WBC during the follow-up was also associated with an increased risk of MetS.

Conclusions

Total WBC counts, and some subtypes, were positively associated with MetS as well as hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, all components of MetS.

Trial registration

Controlled-Trials.comISRCTN35739639.