Associations Between Individual Characteristics and Blood Eosinophil Counts in Adults with Asthma or COPD
Associations Between Individual Characteristics and Blood Eosinophil Counts in Adults with Asthma or COPD
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DOI：
10.1016/j.jaip.2019.12.019
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发表时间：
2020-05-01
影响因子：
9.4
通讯作者：
Zeiger, Robert S.
中科院分区：
文献类型：
--
作者：
Caspard, Herve;Ambrose, Christopher S.;Zeiger, Robert S.
背景：在哮喘和慢性阻塞性肺疾病(COPD)患者中，血嗜酸性粒细胞(BeOS)计数升高是炎症反应的标志，与预后不良相关。目的探讨哮喘、慢性阻塞性肺疾病(COPD)和非哮喘/COPD对照人群的个体特征与BeOS计数的相关性。方法2001-2016年度国家健康与营养调查中，18岁及以上哮喘或COPD患者和非哮喘/COPD对照人群根据卫生保健从业者的诊断确定其个体特征。调查了BeOS计数与年龄、性别、种族/民族、体重指数和吸烟状况之间的关系。统计分析包括国家健康和营养检查调查，多阶段抽样和抽样重量。结果哮喘患者的EOS计数显著高于非哮喘/COPD对照组。COPD组和非哮喘/COPD对照组之间差异无统计学意义。在所有三个人群中，BeOS计数的中位数在男性(15%-20%)和体重指数较高的人群(∼5%-25%)中持续较高，而在黑人个体中较低(15%-20%)。在非哮喘/COPD对照组中，BeOS计数随年龄增加而增加，但在哮喘或COPD患者中则不随年龄增加。在非哮喘/COPD对照组和哮喘患者中，现吸烟者和既往吸烟者的BeOS计数高于从不吸烟者，但在COPD患者中，BeOS计数与吸烟状态之间没有相关性。结论在哮喘或COPD患者中，在解释BeOS计数时应考虑性别、种族和体重指数。哮喘患者也应考虑吸烟史。未来的研究应该评估根据人口统计学因素调整后的BeOS计数与临床结果(如哮喘或COPD加重)之间的关系。
BackgroundElevated blood eosinophil (bEOS) counts are markers of inflammation associated with poorer outcomes in individuals with asthma and chronic obstructive pulmonary disease (COPD). However, little is known about factors impacting the variability of bEOS counts in individuals with these conditions.ObjectiveTo determine the association between individual characteristics and bEOS counts in individuals with asthma, COPD, and nonasthma/COPD controls.MethodsParticipants in the National Health and Nutrition Examination Surveys (2001-2016) aged 18 years or older with asthma or COPD and nonasthma/COPD controls were identified on the basis of diagnoses by health care practitioners. Associations between bEOS counts and age, sex, race/ethnicity, body mass index, and smoking status were investigated. Statistical analyses incorporated National Health and Nutrition Examination Surveys multistage sampling and sampling weights.ResultsbEOS counts were significantly higher in individuals with asthma than in nonasthma/COPD controls. There was no significant difference between individuals with COPD and nonasthma/COPD controls. Across all 3 populations, median bEOS counts were consistently higher in men (15%-20%) and in those with higher body mass index (∼5%-25%) and lower in individuals of black race (15%-20%). bEOS counts increased with age in nonasthma/COPD controls but not in individuals with asthma or COPD. Among nonasthma/COPD controls and individuals with asthma, bEOS counts were higher in current and former smokers compared with never smokers, but no such association was found between bEOS counts and smoking status in individuals with COPD.ConclusionsIn individuals with asthma or COPD, sex, race, and body mass index should be considered when interpreting bEOS counts. Smoking history should also be considered in individuals with asthma. Future research should evaluate the association between bEOS counts adjusted for demographic factors and clinical outcomes, such as asthma or COPD exacerbations.