The influence of individual characteristics and non-respiratory diseases on blood eosinophil count

Rita Amaral* (Corresponding Author), Tiago Jacinto, Andrei Malinovschi, Christer Janson, David Price, João A. Fonseca, Kjell Alving

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
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BackgroundBlood eosinophil (B-Eos) count is an emerging biomarker in the management of respiratory disease but determinants of B-Eos count besides respiratory disease are poorly described. Therefore, we aimed to evaluate the influence of non-respiratory diseases on B-Eos count, in comparison to the effect on two other biomarkers: fraction of exhaled nitric oxide (FeNO) and C-reactive protein (CRP), and to identify individual characteristics associated with B-Eos count in healthy controls.MethodsChildren/adolescents (<18 years) and adults with complete B-Eos data from the US National Health and Nutritional Examination Surveys 2005–2016 were included, and they were divided into having respiratory diseases (n = 3333 and n = 7,894, respectively) or not having respiratory disease (n = 8944 and n = 15,010, respectively). After excluding any respiratory disease, the association between B-Eos count, FeNO or CRP, and non-respiratory diseases was analyzed in multivariate models and multicollinearity was tested. After excluding also non-respiratory diseases independently associated with B-Eos count (giving healthy controls; 8944 children/adolescents and 5667 adults), the independent association between individual characteristics and B-Eos count was analyzed.ResultsIn adults, metabolic syndrome, heart disease or stroke was independently associated with higher B-Eos count (12%, 13%, and 15%, respectively), whereas no associations were found with FeNO or CRP. In healthy controls, male sex or being obese was associated with higher B-Eos counts, both in children/adolescents (15% and 3% higher, respectively) and adults (14% and 19% higher, respectively) (p < 0.01 all). A significant influence of race/ethnicity was also noted, and current smokers had 17% higher B-Eos count than never smokers (p < 0.001).ConclusionsNon-respiratory diseases influence B-Eos count but not FeNO or CRP. Male sex, obesity, certain races/ethnicities, and current smoking are individual characteristics or exposures that are associated with higher B-Eos counts. All these factors should be considered when using B-Eos count in the management of respiratory disease.
Original languageEnglish
Article numbere12036
Number of pages12
JournalClinical and Translational Allergy
Issue number4
Early online date3 Jun 2021
Publication statusPublished - 30 Jun 2021

Bibliographical note

Funding information
Stiftelsen för Strategisk Forskning; Hjärt‐Lungfonden; Swedish Foundation for StrategicResearch; the Swedish Heart and Lung Foundation
The authors would like to thank the Centers for Disease Control and Prevention, National Center for Health Statistics, for providing the NHANES 2005–2016 data. This work was funded by the Swedish Foundation for Strategic Research, and the Swedish Heart and Lung Foundation.


  • airway inflammation
  • blood eosinophils
  • eosinophilic inflammation
  • respiratory diseases


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