White blood cell count and all-cause and cause-specific mortality in the Guangzhou biobank cohort study

BMC Public Health. 2018 Nov 6;18(1):1232. doi: 10.1186/s12889-018-6073-6.

Abstract

Background: Several studies have shown positive associations between higher WBC count and deaths from all-causes, CHD, stroke and cancer among occidental populations or developed countries of Asia. No study on the association of WBC count with all-cause and cause-specific mortality in Chinese populations was reported. We studied this using prospective data from a large Chinese cohort.

Methods: We used prospective data from the Guangzhou Biobank Cohort Study (GBCS), a total of 29,925 participants in present study. A Cox proportional hazards regression model was used to estimate the hazard ratios (HR) and 95% confidence interval (CI).

Results: The hazard ratios (HR) for all-cause, CHD, and respiratory disease mortality for the highest decile of WBC count (women > 8.2 × 109/L; men > 8.8 × 109/L) was 1.83 (95% confidence interval (CI) 1.54, 2.17), 3.02 (95% CI 1.84, 4.98) and 2.52 (95% CI 1.49, 4.27), respectively, after adjusting for multiple potential confounders. The associations were similar when deaths during the first 2 years of follow-up were excluded. After further adjusting for pulmonary function, the highest decile of WBC count was associated with 90% higher risk of respiratory disease mortality (HR 1.90, 95% CI 1.08, 3.33). No evidence for an association between higher WBC count and cancer mortality was found. Sub-type analysis showed that only granulocyte count remained significantly predictive of all-cause, CHD, and respiratory disease mortality.

Conclusions: Elevated WBC, specifically granulocyte, count was associated with all-cause, CHD and respiratory mortality in southern Chinese. Further investigation is warranted to clarify whether decreasing inflammation would attenuate WBC count associated mortality.

Keywords: All-cause mortality; Cause-specific mortality; Granulocyte count; Prospective cohort study; White blood cell count.

MeSH terms

  • Aged
  • Biological Specimen Banks
  • Cause of Death*
  • China / epidemiology
  • Female
  • Humans
  • Leukocyte Count / statistics & numerical data*
  • Male
  • Middle Aged
  • Prospective Studies