Solanki Neha, Fakhry Battoul, Attaway Amy, Gaston Benjamin, Cahill Katherine N, Newcomb Dawn C, Zein Joe G
Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio.
Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
J Allergy Clin Immunol Glob. 2025 Jul 22;4(4):100541. doi: 10.1016/j.jacig.2025.100541. eCollection 2025 Nov.
Significant sex differences occur in asthma phenotypes across the lifespan. Platelet activation is associated with a steroid-refractory asthma phenotype.
We sought to test the hypothesis that higher platelet counts in females are associated with increased prevalence and severity of asthma compared with males.
We conducted a cross-sectional analysis using data from participants' baseline visit in the UK Biobank. Binomial multivariable logistic regression was used to adjust for age, body mass index, sex, race, smoking status, serum C-reactive protein, absolute eosinophil count, and absolute neutrophil count.
Of the 351,203 patients included in the analysis, 5.7% had asthma, 2% met the British Thoracic Society criteria for moderate to severe asthma, and 57.4% were female. Female sex was associated with higher platelet counts among participants with or without asthma ( < .001). Median platelet counts were higher by 30 × 10/μL in females with asthma when compared with males with asthma (median [interquartile range], 271.1 [235.0-312.0] vs 241.0 [209.0-279.4] × 10/μL, < .001, respectively). Among participants with asthma, higher platelet counts were also associated with increased asthma severity ( < .001). Platelet counts correlated positively with the blood absolute eosinophil count ( = 0.104, < .001), blood neutrophil count ( = 0.254, < .001), and C-reactive protein ( = 0.183, < .001).
These findings suggest that platelet counts are associated with asthma and inflammation in both sexes and can serve as a potential biomarker for asthma severity with differential effects across the sexes. Future studies including mechanistic studies should characterize the interaction between sex hormones, platelet activation, and asthma severity.
在整个生命周期中，哮喘表型存在显著的性别差异。血小板活化与激素难治性哮喘表型相关。
我们试图检验这一假设，即与男性相比，女性较高的血小板计数与哮喘患病率和严重程度增加有关。
我们使用英国生物银行参与者基线访视的数据进行横断面分析。采用二项多变量逻辑回归对年龄、体重指数、性别、种族、吸烟状况、血清C反应蛋白、绝对嗜酸性粒细胞计数和绝对中性粒细胞计数进行校正。
在纳入分析的351203名患者中，5.7%患有哮喘，2%符合英国胸科学会中重度哮喘标准，57.4%为女性。无论有无哮喘，女性性别与较高的血小板计数相关（P<0.001）。与患有哮喘的男性相比，患有哮喘的女性血小板计数中位数高30×10⁹/μL（中位数[四分位间距]，分别为271.1[235.0 - 312.0]对241.0[209.0 - 279.4]×10⁹/μL，P<0.001）。在患有哮喘的参与者中，较高的血小板计数也与哮喘严重程度增加相关（P<0.001）。血小板计数与血液绝对嗜酸性粒细胞计数（r = 0.104，P<0.001）、血液中性粒细胞计数（r = 0.254，P<0.001）和C反应蛋白（r = 0.183，P<0.001）呈正相关。
这些发现表明，血小板计数与男女两性的哮喘和炎症相关，可作为哮喘严重程度的潜在生物标志物，且在两性中具有不同影响。未来包括机制研究在内的研究应明确性激素、血小板活化和哮喘严重程度之间的相互作用。
