普通人群的血液嗜酸性粒细胞计数：典型值和潜在的混杂因素
2020/03/11
摘要
在慢性呼吸道疾病的管理中，例如哮喘和慢性阻塞性肺疾病（COPD），人们对血液嗜酸性粒细胞计数的兴趣日益浓厚。即使这样，普通人群中血液嗜酸性粒细胞的典型水平以及潜在的混杂因素对这些水平的影响仍未明确。我们从奥地利普通人群中招募的11042名受试者的随机样本中测量了血液嗜酸性粒细胞计数。我们（1）确定与血液嗜酸性粒细胞计数高（> 75％）有关的因素；（2）排除具有这些因素的受试者，评估“健康”亚人群（n = 3641）中嗜酸粒细胞计数的中位数。我们发现：（1）在整个队列中，年龄≤18岁（OR 2.41），哮喘（OR 2.05），目前吸烟（OR 1.72），皮肤点刺试验阳性（OR 1.64），COPD（OR 1.56），代谢综合征（OR 1.41），男性（OR 1.36）和肥胖症（OR 1.16）与高嗜酸性粒细胞计数显著相关（二元多变量logistic回归分析）（p <0.05），并且因素之间具有相加作用；（2）在排除这些因素之后，在18岁以上的人群中，男性的血液嗜酸性粒细胞计数高于女性（中位数分别为120 [5％-95％CI：30-330]与100 [30-310]细胞/µL）且不随年龄变化而变化。成年人中的嗜酸性粒细胞中位数大大低于目前被认为是正常的数值，不会随青春期后的年龄变化而变化，但受到多种因素的影响，并具有相加作用。这些观察将有助于临床实践中对血液嗜酸性粒细胞水平的解释。
Blood eosinophil count in the general population: typical values and potential confounders.
Hartl S, Breyer MK, Burghuber OC, Ofenheimer A, Schrott A, Urban MH, Agusti A, Studnicka M, Wouters EFM, Breyer-Kohansal R.
Abstract
There is growing interest in blood eosinophil counts in the management of chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease [COPD]). Despite this, typical blood eosinophil levels in the general population, and the impact of potential confounders on these levels have not been clearly defined. We measured blood eosinophil counts in a random sample of 11 042 subjects recruited from the general population in Austria. We then: (1) identified factors associated with high blood eosinophil counts (>75th percentile); and, (2) excluded subjects with these factors to estimate median blood eosinophil counts in a "healthy" sub-population (n=3641).We found that: (1) in the entire cohort, age ≤18 years (odds ratio [OR] 2.41), asthma (OR 2.05), current smoking (OR 1.72), positive skin prick test (OR 1.64), COPD (OR 1.56), metabolic syndrome (OR 1.41), male sex (OR 1.36) and obesity (OR 1.16) were significantly (p<0.05) associated with high blood eosinophil counts (binary multivariable logistic regression analysis); and had an additive effect; (2) after excluding these factors, in those older than 18 years, blood eosinophil counts were higher in males than in females (median 120 [5%-95% CI: 30-330] versus 100 [30-310] cells·µL-1, respectively) and did not change with age. Median blood eosinophil counts in adults are considerably lower than those currently regarded as normal, do not change with age beyond puberty, but are significantly influenced by a variety of factors which have an additive effect. These observations will contribute to the interpretation of blood eosinophil levels in clinical practice.
在慢性呼吸道疾病的管理中，例如哮喘和慢性阻塞性肺疾病（COPD），人们对血液嗜酸性粒细胞计数的兴趣日益浓厚。即使这样，普通人群中血液嗜酸性粒细胞的典型水平以及潜在的混杂因素对这些水平的影响仍未明确。我们从奥地利普通人群中招募的11042名受试者的随机样本中测量了血液嗜酸性粒细胞计数。我们（1）确定与血液嗜酸性粒细胞计数高（> 75％）有关的因素；（2）排除具有这些因素的受试者，评估“健康”亚人群（n = 3641）中嗜酸粒细胞计数的中位数。我们发现：（1）在整个队列中，年龄≤18岁（OR 2.41），哮喘（OR 2.05），目前吸烟（OR 1.72），皮肤点刺试验阳性（OR 1.64），COPD（OR 1.56），代谢综合征（OR 1.41），男性（OR 1.36）和肥胖症（OR 1.16）与高嗜酸性粒细胞计数显著相关（二元多变量logistic回归分析）（p <0.05），并且因素之间具有相加作用；（2）在排除这些因素之后，在18岁以上的人群中，男性的血液嗜酸性粒细胞计数高于女性（中位数分别为120 [5％-95％CI：30-330]与100 [30-310]细胞/µL）且不随年龄变化而变化。成年人中的嗜酸性粒细胞中位数大大低于目前被认为是正常的数值，不会随青春期后的年龄变化而变化，但受到多种因素的影响，并具有相加作用。这些观察将有助于临床实践中对血液嗜酸性粒细胞水平的解释。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(Eur Respir J (IF: 11.807) 2020 Feb 14. pii: 1901874. doi: 10.1183/13993003.01874-2019. [Epub ahead of print])
(Eur Respir J (IF: 11.807) 2020 Feb 14. pii: 1901874. doi: 10.1183/13993003.01874-2019. [Epub ahead of print])
Blood eosinophil count in the general population: typical values and potential confounders.
Hartl S, Breyer MK, Burghuber OC, Ofenheimer A, Schrott A, Urban MH, Agusti A, Studnicka M, Wouters EFM, Breyer-Kohansal R.
Abstract
There is growing interest in blood eosinophil counts in the management of chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease [COPD]). Despite this, typical blood eosinophil levels in the general population, and the impact of potential confounders on these levels have not been clearly defined. We measured blood eosinophil counts in a random sample of 11 042 subjects recruited from the general population in Austria. We then: (1) identified factors associated with high blood eosinophil counts (>75th percentile); and, (2) excluded subjects with these factors to estimate median blood eosinophil counts in a "healthy" sub-population (n=3641).We found that: (1) in the entire cohort, age ≤18 years (odds ratio [OR] 2.41), asthma (OR 2.05), current smoking (OR 1.72), positive skin prick test (OR 1.64), COPD (OR 1.56), metabolic syndrome (OR 1.41), male sex (OR 1.36) and obesity (OR 1.16) were significantly (p<0.05) associated with high blood eosinophil counts (binary multivariable logistic regression analysis); and had an additive effect; (2) after excluding these factors, in those older than 18 years, blood eosinophil counts were higher in males than in females (median 120 [5%-95% CI: 30-330] versus 100 [30-310] cells·µL-1, respectively) and did not change with age. Median blood eosinophil counts in adults are considerably lower than those currently regarded as normal, do not change with age beyond puberty, but are significantly influenced by a variety of factors which have an additive effect. These observations will contribute to the interpretation of blood eosinophil levels in clinical practice.
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