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American Journal of Epidemiology Advance Access published online on October 12, 2005
American Journal of Epidemiology, doi:10.1093/aje/kwi326
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received February 23, 2005
Accepted June 24, 2005

ORIGINAL CONTRIBUTIONS

White Blood Cell Count and Risk for All-Cause, Cardiovascular, and Cancer Mortality in a Cohort of Koreans

Sun Ha Jee 1*, Jung Yong Park 2, Hyon-Suk Kim 3, Tae Yong Lee 4, and Jonathan M. Samet 5

1 Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
2 Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
3 Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea
4 Department of Preventive Medicine and Public Health, College of Medicine, Chungnam National University, Daejeon, Korea
5 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

* To whom correspondence should be addressed.
Sun Ha Jee, E-mail: jsunha{at}yumc.yonsei.ac.kr


  Abstract

The authors conducted a 10-year prospective cohort study of mortality in relation to white blood cell counts of 437,454 Koreans, aged 40-95 years, who received health insurance from the National Health Insurance Corporation and were medically evaluated in 1993 or 1995, with white blood cell measurement. The main outcome measures were mortality from all causes, all cancers, and all atherosclerotic cardiovascular diseases (ASCVD). Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards models with adjustment for age and potential confounders. During follow-up, 48,757 deaths occurred, with 15,507 deaths from cancer and 11,676 from ASCVD. For men and women, white blood cell count was associated with all-cause mortality and ASCVD mortality but not with cancer mortality. In healthy nonsmokers, a graded association between a higher white blood cell count and a higher risk of ASCVD was observed in men (highest vs. lowest quintile: hazard ratio = 2.10, 95% confidence interval: 1.50, 2.94) and in women (hazard ratio = 1.35, 95% confidence interval: 1.17, 1.56). In healthy smokers, a graded association between a higher white blood cell count and a higher risk of ASCVD was also observed in men (highest vs. lowest quintile: hazard ratio = 1.46, 95% confidence interval: 1.25, 1.72). These findings indicate that the white blood cell count is an independent risk factor for all-cause mortality and for ASCVD mortality.

Keywords: arteriosclerosis; cardiovascular diseases; death; leukocytes; neoplasms.
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