The association between smoking profile, leukocyte count, and inflammatory indices in males: a cross-sectional analysis of the TABARI cohort study at enrollment phase.

Background: Cigarette smoking stands as a prominent contributor to global mortality rates, and its impact spans both immediate and long-term effects on hematological parameters; however, in addition to controversial results in previous studies, its effect on novel inflammatory indices has yet to be thoroughly investigated. Thus, this study aims to assess the impact of various smoking profiles on total white blood cell (WBC) count, WBC differentials, and novel hematologic-inflammatory indices among males.

Methods: This cross-sectional study was conducted on 4039 male adults from the enrollment phase data of the TABARI cohort population in Iran. WBC, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count (AMC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), platelet-to-HDL ratio (PHR), RDW-to-platelet ratio (RPR), lymphocyte-to-HDL ratio (LHR), monocyte-to-HDL ratio (MHR), and neutrophil-to-HDL ratio (NHR) were compared between smokers and nonsmokers and also within smokers with different smoking intensities (pack/year). Comparisons were made by Chi-square test and one-way ANOVA, and further done using multivariate linear regression after adjustment for confounders.

Results: WBC, ANC, ALC, AMC, LMR, PLR, PHR, LHR, MHR, and NHR were significantly higher in smokers compared to nonsmokers in a dose-dependent manner (p < 0.05). The multivariate linear regression showed that among smokers, WBC was 25.3% higher, ANC and ALC were 19.7% higher, and AMC was 12.2% higher compared to nonsmokers (all p < 0.001).

Conclusion: Our results demonstrated that WBC, ANC, ALC, AMC, PHR, LHR, MHR, and NHR exhibit significant dose-dependent elevations in smokers.