中老年人群生活方式因素与白细胞计数的相关性
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摘要
目的探讨中老年人群生活方式因素与外周血总白细胞(WBC)及分类WBC计数的相关性。方法研究人群来源于东风-同济(DFTJ)队列第1次随访调查到的38295名东风汽车公司(DMC)离退休职工。排除患有冠心病(CHD)、中风、癌症,严重心电图异常、WBC计数和关键协变量缺失的人群后,最终纳入22765名研究对象。纳入分析的研究对象均完成了问卷调查、体格检查、生化指标检查和血液样本采集。采用广义线性模型分析生活方式因素与WBC计数的相关性。结果多因素广义线性回归分析结果显示,与各参照组相比,体质指数(BMI)≥28 kg/m~2(β=0.307,P<0.001)、男性腰臀比(WHR)≥0.95或女性WHR≥0.90(β=0.298,P<0.001)、现在吸烟量≥20支/d(β=0.690,P<0.001)、夜间睡眠≥9 h(β=0.058,P=0.013)的人群,其总WBC计数显著升高;而现在饮酒量≥60 g/d(β=-0.230,P<0.001)、运动量≥42 MET-h/周(β=-0.085,P=0.001)的人群,其总WBC计数显著降低。随着低风险生活方式因素增多,其与WBC计数之间的负相关强度逐渐增大。结论中老年人群保持正常BMI和较低WHR、不吸烟、适量饮酒、保持适量睡眠和较高运动量等低风险生活方式因素与WBC计数降低呈显著相关。随着低风险生活方式因素的增多,其与WBC计数之间的负相关强度逐渐增大。
Objective To analyze the correlations of lifestyle factors with peripheral total and differential white blood cell(WBC)counts in the middle-aged and elderly populations.Methods All participants were from the Dongfeng-Tongji(DFTJ)cohort,including 38295 retired employees from the Dongfeng Motor Corporation(DMC)at the first follow-up survey.After excluding participants with coronary heart disease(CHD),stroke,cancer,or severely abnormal electrocardiogram and those with missing data of WBC count or important covariates,finally a total of 22765 participants were included in this study.All participants completed baseline questionnaires,physical examinations,clinical biochemical tests and blood sample collection.Generalized linear models were used to analyze the correlations of lifestyle factors with total and differential WBC count.Results Compared with the respective reference groups,participants with body mass index(BMI)≥28 kg/m~2(β=0.307,P<0.001),waist-to-hip ratio(WHR)≥0.95(men)/≥0.90(women)(β=0.298,P<0.001),current smoking ≥20 cigarettes/day(β=0.690,P<0.001),nighttime sleep duration ≥9 h/day(β=0.058,P=0.013)had significantly higher total WBC count,while participants with alcohol consumption of ≥60 g/day(β=-0.230,P<0.001),physical activity level ≥42 MET-h/week(β=-0.085,P=0.001)had significantly lower total WBC count.Low-risk lifestyle factors were negatively correlated with total and differential WBC counts,and the negative correlation coefficients increased as low-risk lifestyle factors increased.ConclusionNormal BMI,low WHR,non-current smoking,light alcohol consumption,moderate nighttime sleep duration and high physical activity are significantly correlated with decreased WBC count.Low-risk lifestyle factors are negatively correlated with WBC count,and the negative correlation coefficients increase as low-risk lifestyle factors increased.
Objective To analyze the correlations of lifestyle factors with peripheral total and differential white blood cell(WBC)counts in the middle-aged and elderly populations.Methods All participants were from the Dongfeng-Tongji(DFTJ)cohort,including 38295 retired employees from the Dongfeng Motor Corporation(DMC)at the first follow-up survey.After excluding participants with coronary heart disease(CHD),stroke,cancer,or severely abnormal electrocardiogram and those with missing data of WBC count or important covariates,finally a total of 22765 participants were included in this study.All participants completed baseline questionnaires,physical examinations,clinical biochemical tests and blood sample collection.Generalized linear models were used to analyze the correlations of lifestyle factors with total and differential WBC count.Results Compared with the respective reference groups,participants with body mass index(BMI)≥28 kg/m~2(β=0.307,P<0.001),waist-to-hip ratio(WHR)≥0.95(men)/≥0.90(women)(β=0.298,P<0.001),current smoking ≥20 cigarettes/day(β=0.690,P<0.001),nighttime sleep duration ≥9 h/day(β=0.058,P=0.013)had significantly higher total WBC count,while participants with alcohol consumption of ≥60 g/day(β=-0.230,P<0.001),physical activity level ≥42 MET-h/week(β=-0.085,P=0.001)had significantly lower total WBC count.Low-risk lifestyle factors were negatively correlated with total and differential WBC counts,and the negative correlation coefficients increased as low-risk lifestyle factors increased.ConclusionNormal BMI,low WHR,non-current smoking,light alcohol consumption,moderate nighttime sleep duration and high physical activity are significantly correlated with decreased WBC count.Low-risk lifestyle factors are negatively correlated with WBC count,and the negative correlation coefficients increase as low-risk lifestyle factors increased.
引文
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[19]Jensen E J,Pedersen B,Frederiksen R,et al.Prospective study on the effect of smoking and nicotine substitution on leucocyte blood counts and relation between blood leucocytes and lung function[J].Thorax,1998,53(9):784-789.
[20]Nakanishi N,Yoshida H,Okamoto M,et al.Association of alcohol consumption with white blood cell count:a study of Japanese male office workers[J].J Intern Med,2010,253(3):367-374.
[21]Mostofsky E,Chahal H S,Mukamal K J,et al.Alcohol and immediate risk of cardiovascular events:a systematic review and dose-response meta-analysis[J].Circulation,2016,133(10):979-987.
[22]Hale L,Parente V,Dowd J B,et al.Fibrinogen may mediate the association between long sleep duration and coronary heart disease[J].J Sleep Res,2013,22(3):305-314.
[23]Petersen A M,Pedersen B K.The anti-inflammatory effect of exercise[J].J Appl Physiol(1985),2005,98(4):1154-1162.
[24]World Health Organization.Major NCDs and their risk factors[EB/OL].(2016-04-07)[2018-04-09].http://www.who.int/ncds/introduction/en/.
[2]Tang S,Ehiri J,Long Q.China’s biggest,most neglected health challenge:non-communicable diseases[J].Infect Dis Poverty,2013,2(1):7.
[3]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(1):1-8.
[4]Oikonomou E,Tousoulis D.Inflammation:apathogenetic mechanism or a mediator,linking risk factors and cardiovascular disease[J].Int J Cardiol,2018,264(1):170-171.
[5]Lv J,Yu C,Guo Y,et al.Adherence to a healthy lifestyle and the risk of type 2diabetes in Chinese adults[J].Int J Epidemiol,2017,46(5):1410-1420.
[6]Lv J,Yu C,Guo Y,et al.Adherence to healthy lifestyle and cardiovascular diseases in the Chinese population[J].J Am Coll Cardiol,2017,69(9):1116-1125.
[7]Sj9gren P,Cederholm T,Heimbürger M,et al.Simple advice on lifestyle habits and long-term changes in biomarkers of inflammation and vascular adhesion in healthy middle-aged men[J].Eur J Clin Nutr,2010,64(12):1450-1456.
[8]Shivappa N,Godos J,Hèbert J R,et al.Dietary inflammatory index and cardiovascular risk and mortality-a Meta-analysis[J].Nutrients,2018,10(2):pii:E200.doi:10.3390/nu10020200.
[9]Elosua R,Bartali B,Ordovas J M,et al.Association between physical activity,physical performance,and inflammatory biomarkers in an elderly population:the InCHIANTI study[J].JGerontol A Biol Sci Med Sci,2005,60(6):760-767.
[10]Madjid M,Awan I,Willerson J T,et al.Leukocyte count and coronary heart disease:implications for risk assessment[J].JAm Coll Cardiol,2004,44(10):1945-1956.
[11]何美安,张策,朱江,等.东风-同济队列研究:研究方法及调查对象基线和第一次随访特征[J].中华流行病学杂志,2016,37(4):480-485.
[12]陈春明.中国成人体质指数分类的推荐意见简介[J].中华预防医学杂志,2001,35(5):349-350.
[13]World Health Organization.Waist circumference and waisthip ratio:report of a WHO expert consultation,Geneva,8-11December 2008[R].World Health Organization,Geneva,Switzerland,2011.
[14]Krittanawong C,Tunhasiriwet A,Wang Z,et al.Association between short and long sleep durations and cardiovascular outcomes:a systematic review and meta-analysis[J].Eur Heart J Acute Cardiovasc Care,2017,69(11):2048872617741733.
[15]Eckel R H,Jakicic J M,Ard J D,et al.2013 AHA/ACCguideline on lifestyle management to reduce cardiovascular risk:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63(25Pt.B):2960-2984.
[16]Gebrelibanos M,Tesfaye D,Raghavendra Y,et al.Nutritional and health implications of legumes[J].Int J Pharm Sci Res,2013,4(4):1269-1279.
[17]Fisch I R,Freedman S H.Smoking,oral contraceptives,and obesity.Effects on white blood cell count[J].JAMA,1975,234(5):500-506.
[18]Trayhurn P,Wood I S.Signalling role of adipose tissue:adipokines and inflammation in obesity[J].Biochem Soc Trans,2005,33(Pt 5):1078-1081.
[19]Jensen E J,Pedersen B,Frederiksen R,et al.Prospective study on the effect of smoking and nicotine substitution on leucocyte blood counts and relation between blood leucocytes and lung function[J].Thorax,1998,53(9):784-789.
[20]Nakanishi N,Yoshida H,Okamoto M,et al.Association of alcohol consumption with white blood cell count:a study of Japanese male office workers[J].J Intern Med,2010,253(3):367-374.
[21]Mostofsky E,Chahal H S,Mukamal K J,et al.Alcohol and immediate risk of cardiovascular events:a systematic review and dose-response meta-analysis[J].Circulation,2016,133(10):979-987.
[22]Hale L,Parente V,Dowd J B,et al.Fibrinogen may mediate the association between long sleep duration and coronary heart disease[J].J Sleep Res,2013,22(3):305-314.
[23]Petersen A M,Pedersen B K.The anti-inflammatory effect of exercise[J].J Appl Physiol(1985),2005,98(4):1154-1162.
[24]World Health Organization.Major NCDs and their risk factors[EB/OL].(2016-04-07)[2018-04-09].http://www.who.int/ncds/introduction/en/.
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