White blood cell count is associated with carotid and femoral atherosclerosis

Atherosclerosis. 2012 Mar;221(1):275-81. doi: 10.1016/j.atherosclerosis.2011.12.038. Epub 2012 Jan 4.


Objective: Chronic low-grade inflammation is associated with atherosclerosis. Ultrasound imaging allows measurement of intima-media thickness (IMT) and plaque. We investigated the association between inflammatory markers and carotid and femoral atherosclerosis.

Methods: We studied 554 subjects with primary dyslipidemia (57% men, median age 49 years) and 246 age- and sex-matched normolipidemic subjects. Carotid and femoral arteries were imaged bilaterally with a standardized protocol. Mean and maximum common carotid IMT (CC-IMT and MaxCC-IMT) and common femoral IMT (F-IMT and MaxF-IMT), and carotid and femoral plaque were assessed. Carotid atherosclerosis was defined by CC-IMT and/or plaque height >75th percentile of a reference population. White blood cell count (WBCC) was measured in all subjects. High-sensitivity C-reactive protein (CRP) was measured in 330 dyslipidemic subjects.

Results: The age- and sex-adjusted probability of carotid atherosclerosis and femoral plaque increased by 20% (odds ratio [OR] 1.20; 95% CI, 1.10-1.31) and 25% (1.25; 1.13-1.38), respectively, for each 1000/mm(3) WBCC increment. WBCC was associated with age- and sex-adjusted CC-IMT and MaxCC-IMT (p<0.05, both), and F-IMT and MaxF-IMT (p<0.001, both). Adjustment for cardiovascular risk factors did not influence these associations. CRP was associated with CC-IMT and MaxCC-IMT (p<0.05, both), but the associations disappeared after adjustment for body mass index. CRP was unrelated to carotid plaque or measures of femoral atherosclerosis.

Conclusions: WBCC, but not CRP, related to early and advanced measures of atherosclerosis independently of risk factors. Our findings support using the heretofore undervalued WBCC as an easy-to-measure, low-cost diagnostic marker of atherosclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atherosclerosis / blood*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / immunology
  • C-Reactive Protein / analysis
  • Carotid Artery Diseases / blood*
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / immunology
  • Carotid Intima-Media Thickness
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Femoral Artery* / diagnostic imaging
  • Humans
  • Inflammation Mediators / blood
  • Leukocyte Count*
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Spain


  • Inflammation Mediators
  • C-Reactive Protein