Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Hye Yun Park and Yoosoo Chang contributed equally as first authors.
Eur Respir J. 2021 Oct 7;58(4). doi: 10.1183/13993003.03823-2020. Print 2021 Oct.
The impact of blood eosinophil counts on the development of chronic obstructive lung disease (COPD) is unknown. We investigated whether a higher blood eosinophil count was associated with the risk of developing obstructive lung disease (OLD) in a large cohort of men and women free from lung disease at baseline.
This was a cohort study of 359 456 Korean adults without a history of asthma and without OLD at baseline who participated in health screening examinations including spirometry. OLD was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV)/forced vital capacity (FVC) <0.7 and FEV <80% predicted.
After a median (interquartile range) follow-up of 5.6 (2.9-9.2) years, 5008 participants developed incident OLD (incidence rate 2.1 (95% CI 2.1-2.2) per 1000 person-years). In the fully adjusted model, the hazard ratios for incident OLD comparing eosinophil counts of 100- <200, 200- <300, 300- <500 and ≥500 <100 cells·μL were 1.07 (95% CI 1.00-1.15), 1.30 (95% CI 1.20-1.42), 1.46 (95% CI 1.33-1.60) and 1.72 (95% CI 1.51-1.95), respectively (p<0.001). These associations were consistent in clinically relevant subgroups, including never-, ex- and current smokers.
In this large longitudinal cohort study, blood eosinophil counts were positively associated with the risk of developing of OLD. Our findings indicate a potential role of the eosinophil count as an independent risk factor for developing COPD.
目前尚不清楚血液嗜酸性粒细胞计数对慢性阻塞性肺疾病（COPD）发展的影响。我们在一个基线时无肺部疾病的大型男女队列中研究了较高的血液嗜酸性粒细胞计数是否与阻塞性肺病（OLD）的发病风险相关。
这是一项队列研究，共纳入 359456 名韩国成年人，基线时无哮喘病史且无 OLD，参加了包括肺量测定法在内的健康筛查检查。OLD 的定义为支气管扩张剂后 1 秒用力呼气量（FEV）/用力肺活量（FVC）<0.7 和 FEV <80%预测值。
中位（四分位间距）随访 5.6（2.9-9.2）年后，5008 名参与者发生了 OLD 事件（发生率为 2.1（95%可信区间 2.1-2.2）/1000 人年）。在完全调整的模型中，比较嗜酸性粒细胞计数为 100-<200、200-<300、300-<500 和≥500<100 个细胞·μL 时，OLD 事件的风险比分别为 1.07（95%可信区间 1.00-1.15）、1.30（95%可信区间 1.20-1.42）、1.46（95%可信区间 1.33-1.60）和 1.72（95%可信区间 1.51-1.95）（p<0.001）。这些关联在包括从未吸烟、曾吸烟和当前吸烟的临床相关亚组中是一致的。
在这项大型纵向队列研究中，血液嗜酸性粒细胞计数与 OLD 发病风险呈正相关。我们的研究结果表明，嗜酸性粒细胞计数可能是 COPD 发展的一个独立危险因素。
