Association of immune cell composition with the risk factors and incidence of acute coronary syndrome

Xian Shi; Minghan Qu; Yi Jiang; Ziwei Zhu; Chengguqiu Dai; Minghui Jiang; Lin Ding; Yu Yan; Chaolong Wang; Xiaomin Zhang; Shanshan Cheng; Xingjie Hao

doi:10.1186/s13148-023-01527-4

Association of immune cell composition with the risk factors and incidence of acute coronary syndrome

Clin Epigenetics. 2023 Jul 17;15(1):115. doi: 10.1186/s13148-023-01527-4.

Authors

Xian Shi¹, Minghan Qu¹, Yi Jiang¹, Ziwei Zhu¹, Chengguqiu Dai¹, Minghui Jiang¹, Lin Ding¹, Yu Yan¹, Chaolong Wang¹, Xiaomin Zhang², Shanshan Cheng³, Xingjie Hao⁴

Affiliations

¹ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. sscheng@hust.edu.cn.
⁴ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. xingjie@hust.edu.cn.

Abstract

Background: Although immune cells are involved in acute coronary syndrome (ACS), few studies have explored the association of incident ACS with the relative immune cell proportions. We aimed to investigate the association of immune cell proportions with the incidence and risk factors of ACS in the Dongfeng-Tongji cohort.

Methods: We conducted the analyses with 38,295 subjects from the first follow-up of the Dongfeng-Tongji cohort, including DNA methylation profiles for 1570 individuals. The proportions of immune cell types were observed from routine blood tests or estimated from DNA methylation profiles. For both observed and estimated immune cell proportions, we tested their associations with risk factors of ACS by multivariable linear regression models. In addition, the association of each immune cell proportion with incident ACS was assessed by the Cox regression model and conditional logistic regression model, respectively, adjusting for the risk factors of ACS.

Findings: The proportions of lymphocytes, monocytes, and neutrophils showed strong associations with sex, followed by diabetes. Moreover, sex and current smoking were the two factors with strongest association with the proportions of lymphocyte subtypes. The hazard ratio (HR) and 95% confidence interval (CI) of incident ACS per standard deviation (SD) increase in proportions of lymphocytes and neutrophils were 0.91 (0.85-0.96) and 1.10 (1.03-1.16), respectively. Furthermore, the OR (95% CI) of incident ACS per SD increase in proportions of NK cells, CD4⁺ T cells, and B cells were 0.88 (0.78-0.99), 1.15 (1.03-1.30), and 1.13 (1.00-1.26), respectively.

Interpretation: The proportions of immune cells were associated with several risk factors of ACS, including sex, diabetes, and current smoking. In addition, proportion of neutrophils had a risk effect, while proportion of lymphocytes had a protective effect on the incidence of ACS. The protective effect of lymphocytes was probably driven by NK cells.

Keywords: Acute coronary syndrome; DNA methylation; Immune cell composition; Risk factor.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acute Coronary Syndrome* / epidemiology
DNA Methylation
Diabetes Mellitus*
Humans
Incidence
Killer Cells, Natural
Risk Factors