Leukocyte Count Is Better than LDL-C as Predictor of Novel Carotid Atherosclerosis

<b>Background:</b> this retrospective cohort study aimed to identify risk factors and establish cutoff values for the initial development of carotid atherosclerosis (CAS) in middle-aged adults. <b>Methods:</b> from an initial cohort of 3583 participants, we finally analyzed 1141 individuals. The observation group comprised subjects who developed CAS without concomitant fatty liver disease (FLD), using their last normal clinical measurements as predictors. The control group consisted of participants who remained free of both CAS and FLD throughout the follow-up period. Statistical analyses included Student's <i>t</i>-test, Mann-Whitney U test, and chi-square test for group comparisons, along with logistic regression, COX regression, ROC curve analysis, and Kaplan-Meier survival analysis to identify risk factors and determine optimal cutoff values. Repeated-measures ANOVA assessed longitudinal changes. <b>Results:</b> over a mean follow-up of 1.09 years, elevated leukocyte count (AUC: 0.622, 95% CI: 0.540-0.704) and LDL-C (AUC 0.600, 95% CI: 0.516-0.683) were associated with CAS development in middle-aged adults (mean age 49.6 ± 8.0 years). ROC analysis established leukocyte count >5.00 × 10⁹/L and LDL-C >125.1 mg/dL as optimal predictive thresholds. <b>Conclusions:</b> leukocyte count and LDL-C are early warning indicators for CAS development within approximately one year, with leukocyte count showing a slightly stronger correlation with arteriosclerosis progression than LDL-C.