Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada.
Eur Respir J. 2021 May 27;57(5). doi: 10.1183/13993003.00838-2020. Print 2021 May.
The aim of this study was to examine the association between blood eosinophil levels and the decline in lung function in individuals aged >40 years from the general population.
The study evaluated the eosinophil counts from thawed blood in 1120 participants (mean age 65 years) from the prospective population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study. Participants answered interviewer-administered respiratory questionnaires and performed pre-/post-bronchodilator spirometric tests at 18-month intervals; computed tomography (CT) imaging was performed at baseline. Statistical analyses to describe the relationship between eosinophil levels and decline in forced expiratory volume in 1 s (FEV) were performed using random mixed-effects regression models with adjustments for demographics, smoking, baseline FEV, ever-asthma and history of exacerbations in the previous 12 months. CT measurements were compared between eosinophil subgroups using ANOVA.
Participants who had a peripheral eosinophil count of ≥300 cells·µL (n=273) had a greater decline in FEV compared with those with eosinophil counts of <150 cells·µL (n=430; p=0.003) (reference group) and 150-<300 cells·µL (n=417; p=0.003). The absolute change in FEV was -32.99 mL·year for participants with eosinophil counts <150 cells·µL; -38.78 mL·year for those with 150-<300 cells·µL and -67.30 mL·year for participants with ≥300 cells·µL. In COPD, higher eosinophil count was associated with quantitative CT measurements reflecting both small and large airway abnormalities.
A blood eosinophil count of ≥300 cells·µL is an independent risk factor for accelerated lung function decline in older adults and is related to undetected structural airway abnormalities.
本研究旨在探讨在来自一般人群的>40 岁个体中，血液嗜酸性粒细胞水平与肺功能下降之间的关联。
该研究评估了前瞻性人群基础加拿大阻塞性肺病队列研究（CanCOLD）中 1120 名参与者（平均年龄 65 岁）解冻血液中的嗜酸性粒细胞计数。参与者回答了由调查员进行的呼吸问卷，并在 18 个月的间隔内进行了预/后支气管扩张剂肺量计测试；在基线时进行了计算机断层扫描（CT）成像。使用随机混合效应回归模型进行描述嗜酸性粒细胞水平与 1 秒用力呼气量（FEV）下降之间关系的统计分析，并根据人口统计学、吸烟、基线 FEV、既往哮喘和过去 12 个月内加重史进行调整。使用 ANOVA 比较 CT 测量值在嗜酸性粒细胞亚组之间的差异。
外周血嗜酸性粒细胞计数≥300 个细胞·µL（n=273）的参与者与嗜酸性粒细胞计数<150 个细胞·µL（n=430；p=0.003）（参考组）和 150-<300 个细胞·µL（n=417；p=0.003）的参与者相比，FEV 下降更大。嗜酸性粒细胞计数<150 个细胞·µL 的参与者的 FEV 绝对变化为-32.99mL·年；嗜酸性粒细胞计数 150-<300 个细胞·µL 的参与者为-38.78mL·年；嗜酸性粒细胞计数≥300 个细胞·µL 的参与者为-67.30mL·年。在 COPD 中，较高的嗜酸性粒细胞计数与反映小气道和大气道异常的定量 CT 测量值相关。
血液嗜酸性粒细胞计数≥300 个细胞·µL 是老年人肺功能加速下降的独立危险因素，与未检测到的结构性气道异常有关。
