Change of white blood cell level and its clinical significance in obese and non-obese patients with coronary artery disease

Objective: To examine the change of white blood cell level in obese and non-obese patients with coronary heart disease (CHD) and its clinical significance. Methods: Two hundred and thirty patients with CHD were divided into two groups: obesity with CHD [n = 115, body mass index (BMI) ≥28 kg/m² or waist-to-hip ratio (WHR)>0.9 (male) or 0.85>(female)], and non-obesity with CHD (n = 115). Another 130 subjects served as the control group. The degree of coronary stenosis was quantitatively assessed according to the fractional imaging of coronary artery evaluation standard (American Heart Association, 1984) and Gensini scoring system. The changes of the total white blood cell count and white blood cell classification were compared between obese and non-obese patients with CHD. The correlation of the total white blood cell count with obesity index and blood biochemical parameters was analyzed by correlation analysis and multivariate stepwise regression analysis. Results: The total white blood cell count of obesity CHD group was significantly higher than that of non-obesity CHD group and control group [(7.83±2.93), (7.00±1.83) and (6.36±1.72) (10⁹/L, respectively; all P<0.05). The levels of low-density lipoprotein (LDL-C), apolipoprotein-B (ApoB) and Gensini score were also significantly higher in obesity group than in non-obesity group (all P<0.05). The level of apolipoprotein-A (ApoA) was significantly lower in obesity group than in control group (P<0.05), but obesity group and non-obesity group did not differ significantly in ApoA (P>0.05). In obesity group, the total white blood cell count was positively correlated with ApoB while in non-obesity group the total white blood cell count was negatively correlated with ApoA. Conclusion: The count of total white blood cells of obesity patients with coronary heart disease is higher than that of non-obesity coronary heart disease patients. ApoB and ApoA arc the major factors affecting total white blood cells in obesity group and in non-obesity group, respectively.